Healthcare Provider Details

I. General information

NPI: 1144835869
Provider Name (Legal Business Name): BRITTANY BUGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11184 HURON ST STE 10
NORTHGLENN CO
80234-3344
US

IV. Provider business mailing address

150 MAIN ST UNIT 2312
LONGMONT CO
80501-6787
US

V. Phone/Fax

Practice location:
  • Phone: 720-900-4282
  • Fax:
Mailing address:
  • Phone: 414-335-6770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0017637
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: