Healthcare Provider Details

I. General information

NPI: 1336728872
Provider Name (Legal Business Name): HANNAH SAUNDERS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

3425 HAMPTON DR
FORT COLLINS CO
80525-2705
US

V. Phone/Fax

Practice location:
  • Phone: 970-829-0992
  • Fax:
Mailing address:
  • Phone: 414-897-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HANNAH WURSTER
Title or Position: OWNER
Credential: PH.D., LMFT
Phone: 970-829-0992