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Individual

JENNIFER CULLOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LAC

Contact information

Practice address
500 COFFMAN ST STE 204, LONGMONT, CO 80501-5445
(720) 204-8655
Mailing address
500 COFFMAN ST STE 204, LONGMONT, CO 80501-5445
(720) 204-8655

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ACD.0001479
CO
101YM0800X
Mental Health Counselor
Primary
LPC.0017162
CO

Other

Enumeration date
05/04/2018
Last updated
07/19/2024
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