Individual
MR. JONATHAN MICHAEL PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
80 GARDEN CTR STE 48, BROOMFIELD, CO 80020-1777
(720) 336-0675
Mailing address
12609 ZUNI ST APT 304, BROOMFIELD, CO 80020-3825
(480) 206-5524
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0018678
CO
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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