Individual
KELLY CENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4856 INNOVATION DR, FORT COLLINS, CO 80525-5539
(970) 494-4200
(844) 270-1824
Mailing address
4856 INNOVATION DR, FORT COLLINS, CO 80525-5539
(970) 494-4200
(844) 270-1824
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0021265
CO
106S00000X
Behavior Technician
RBT-19-76595
—
172A00000X
Driver
—
—
Other
Enumeration date
03/19/2018
Last updated
03/06/2025
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