Individual
BENJAMIN ROBERT BOMBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4557 DECATUR ST, DENVER, CO 80211-1438
(505) 400-0487
Mailing address
4557 DECATUR ST, DENVER, CO 80211-1438
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFTC.0013873
CO
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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