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General NPI Number Information
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NPI Number | 1851568737
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Entity Type | Organization
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Legal Business Name | RURAL TREATMENT SERVICES
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Dates
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Enumeration Date | 05/10/2008
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Last Update Date | 05/10/2008
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Provider Practice Location Address
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Address Line | 1000 LINCOLN ST SUITE 204
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City | FORT MORGAN
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State | CO
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Zip | 80701-3290
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Country | US
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Telephone | 720-220-8651
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Fax | 303-766-2457
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Provider Business Mailing Address
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Address Line | 1000 LINCOLN ST SUITE 204
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City | FORT MORGAN
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State | CO
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Zip | 80701-3290
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Country | US
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Telephone | 720-220-8651
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Fax | 303-766-2457
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Authorized Official
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Title or Position | PSYCHOLOGIST/DIRECTOR
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Name | DR. ROBERT ABRAHAM WOLFSOHN
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Credential | PSY.D
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Telephone | 720-220-8651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1376
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License Number State | CO
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