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Individual

KATHLEEN J VANDENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
305 CARPENTER RD, FORT COLLINS, CO 80525-4248
(970) 663-3500
(970) 292-0898
Mailing address
305 CARPENTER RD, FORT COLLINS, CO 80525-4248
(970) 663-3500
(970) 292-0898

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2088
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
CO
Enumeration date
08/10/2012
Last updated
06/23/2021
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