Healthcare Provider Details

I. General information

NPI: 1275950636
Provider Name (Legal Business Name): ALISON HARTMAN MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 CASTLE DR
SEVERANCE CO
80550-4874
US

IV. Provider business mailing address

4856 INNOVATION DR STE B
FORT COLLINS CO
80525-5540
US

V. Phone/Fax

Practice location:
  • Phone: 970-795-2100
  • Fax:
Mailing address:
  • Phone: 970-494-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0001326
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: