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General NPI Number Information
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NPI Number | 1316598063
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Entity Type | Organization
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Legal Business Name | AFFINITY THERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1330 QUAIL LAKE LOOP STE 240
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4651
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Country | US
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Telephone | 719-900-3633
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 QUAIL LAKE LOOP STE 240
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4651
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Country | US
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Telephone | 719-900-3633
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. KRISTINE RASMUSSEN DANGREMOND
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Credential | MD
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Telephone | 719-900-3633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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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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