Healthcare Provider Details

I. General information

NPI: 1831667781
Provider Name (Legal Business Name): HANNAH WURSTER PH.D., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E MOUNTAIN AVE STE 215
FORT COLLINS CO
80524-2863
US

IV. Provider business mailing address

149 W OAK ST STE 110
FORT COLLINS CO
80524-7110
US

V. Phone/Fax

Practice location:
  • Phone: 970-829-0992
  • Fax:
Mailing address:
  • Phone: 970-829-0992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0001917
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: