Healthcare Provider Details

I. General information

NPI: 1760283402
Provider Name (Legal Business Name): ANGELA BOLIN RMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MIDPOINT DR STE 202
FORT COLLINS CO
80525-4341
US

IV. Provider business mailing address

2121 MIDPOINT DR STE 202
FORT COLLINS CO
80525-4341
US

V. Phone/Fax

Practice location:
  • Phone: 970-632-9540
  • Fax: 970-682-7007
Mailing address:
  • Phone: 970-632-9540
  • Fax: 970-682-7007

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: