Individual
MS. INGRID VAN HAITSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 COFFMAN ST STE 204, LONGMONT, CO 80501-5445
(720) 893-1683
Mailing address
44 POWDER HORN PL, LONGMONT, CO 80504-1233
(720) 893-1683
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
09928389
CO
Other
Enumeration date
09/12/2016
Last updated
09/13/2024
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