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General NPI Number Information
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NPI Number | 1265152748
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Entity Type | Organization
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Legal Business Name | SUMMIT TOGETHER MENTAL HEALTH, PLLC
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | #1075 1601 29TH ST. SUITE 1292
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City | BOULDER
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State | CO
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Zip | 80301
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Country | US
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Telephone | 513-444-8995
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Fax |
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Provider Business Mailing Address
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Address Line | #1075 1601 29TH ST. SUITE 1292
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City | BOULDER
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State | CO
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Zip | 80301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | JANELLE ADRIENNE CENANA AGUILON
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Credential | APN
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Telephone | 970-614-8842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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