Individual
MS. JACQUELINE SUE VANDENBOVENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-LPC-ATR
Contact information
Practice address
4500 19TH ST, LOT 190, BOULDER, CO 80304-0613
(303) 641-2718
Mailing address
4500 19TH ST, LOT 190, BOULDER, CO 80304-0613
(303) 641-2718
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3918
CO
221700000X
Art Therapist
Primary
05-132
—
Other
Enumeration date
05/16/2007
Last updated
09/11/2025
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