Organization
BLUE BISON PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA THATE BALDASARO PMHNP (OWNER)
(970) 420-3756
Entity
Organization
Contact information
Practice address
40047 COUNTY ROAD 31, AULT, CO 80610-9721
(970) 420-3778
Mailing address
4603 DUSTY SAGE CT UNIT 4, FORT COLLINS, CO 80526-3753
(970) 420-3756
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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