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General NPI Number Information
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NPI Number | 1023528601
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Entity Type | Organization
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Legal Business Name | KATHLEEN RENEE KOELSCH, LLC
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 2627 REDWING RD STE 325
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City | FORT COLLINS
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State | CO
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Zip | 80526-6355
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Country | US
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Telephone | 303-435-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 7163 ORCHARD AVE
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City | FREDERICK
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State | CO
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Zip | 80504-5648
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Country | US
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Telephone | 303-435-3828
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | KATHLEEN RENEE KOELSCH
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Credential | MA, LPCC
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Telephone | 303-435-3828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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