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NPI 1790559029

NPI 1790559029 : ASPEN THERAPY AND WELLNESS LLC : FORT COLLINS, CO

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General NPI Number Information
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    NPI Number           |    1790559029
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    Entity Type          |    Organization 
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    Legal Business Name  |    ASPEN THERAPY AND WELLNESS LLC 
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Dates
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    Enumeration Date     |    11/07/2023
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    Last Update Date     |    11/07/2023
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Provider Practice Location Address
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    Address Line         |    19 OLD TOWN SQ STE 238 
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    City                 |    FORT COLLINS
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    State                |    CO
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    Zip                  |    80524-2471
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    Country              |    US
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    Telephone            |    720-592-7209
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    19 OLD TOWN SQ STE 238 
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    City                 |    FORT COLLINS
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    State                |    CO
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    Zip                  |    80524-2471
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    Country              |    US
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    Telephone            |    720-592-7209
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER, MANAGER
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    Name                 |     JENNIFER  BORLAND 
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    Credential           |    LCSW
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    Telephone            |    720-592-7209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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