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Organization

LIFE UNTANGLED, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE DAWN SOUCIE MS, LPC (LICENSED PROFESSIONAL COUNSELOR)
(970) 520-0738
Entity
Organization

Contact information

Practice address
330 W MAIN ST STE B, STERLING, CO 80751-3177
(970) 520-0738
Mailing address
330 W MAIN ST STE B, STERLING, CO 80751-3177
(970) 520-0738

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
CO

Other

Enumeration date
01/05/2016
Last updated
01/05/2016
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