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Organization

BOULDER COLORADO THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL DUNLAP (OWNER)
(720) 218-0788
Entity
Organization

Contact information

Practice address
2299 PEARL ST, BOULDER, CO 80302-4668
(720) 218-0788
Mailing address
3195 PEARL PKWY APT 312, BOULDER, CO 80301-2468

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
02/20/2024
Last updated
02/21/2024
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