Organization
ROCKY MOUNTAIN MEMORY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN A LAUREN ED.D. (CLINICAL DIRECTOR)
(970) 221-1073
Entity
Organization
Contact information
Practice address
951 LAPORTE AVE, FORT COLLINS, CO 80521-2522
(970) 221-1073
Mailing address
2801 REMINGTON ST STE 1, FORT COLLINS, CO 80525-2566
(970) 221-1073
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1990
CO
225X00000X
Occupational Therapist
1024531
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69323780
—
CO
Enumeration date
09/12/2008
Last updated
05/24/2012
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