Healthcare Provider Details

I. General information

NPI: 1699031062
Provider Name (Legal Business Name): ATTACHMENT & BONDING NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 ARAPAHOE AVE STE 200
BOULDER CO
80303-1032
US

IV. Provider business mailing address

4141 ARAPAHOE AVE STE 200
BOULDER CO
80303-1032
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-1220
  • Fax:
Mailing address:
  • Phone: 303-443-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2692
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATHY KINSKEY
Title or Position: PRINCIPAL
Credential: M.A., L.P.C.
Phone: 303-443-1220