Healthcare Provider Details

I. General information

NPI: 1982971834
Provider Name (Legal Business Name): INTERNATIONAL NEURAL-RENEWAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 HIGH DR
ESTES PARK CO
80517-8529
US

IV. Provider business mailing address

1281 HIGH DR
ESTES PARK CO
80517-8529
US

V. Phone/Fax

Practice location:
  • Phone: 970-586-3301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JULIE STEENHOEK
Title or Position: OWNER
Credential:
Phone: 970-586-3301