Individual
JACOB BENJAMIN KUDEVIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 PLAZA CT N STE 101, LAFAYETTE, CO 80026-1467
(720) 515-4487
Mailing address
2635 JUNIPER AVE, BOULDER, CO 80304-2456
(703) 627-5298
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CO
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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