Organization
ECLIPSE INTEGRATIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WICKERSHAM LPC (OWNER)
(631) 603-8643
Entity
Organization
Contact information
Practice address
4770 BASELINE RD STE 200, BOULDER, CO 80303-2668
(303) 335-0899
Mailing address
PO BOX 7479, BOULDER, CO 80306-7479
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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