Individual
AUTUMN GROUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
214 S WHITCOMB ST, FORT COLLINS, CO 80521-2642
(970) 494-9761
(970) 346-9800
Mailing address
125 CRESTRIDGE ST, FORT COLLINS, CO 80525-3934
(970) 494-9761
(970) 346-9800
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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