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General NPI Number Information
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NPI Number | 1871250001
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Entity Type | Organization
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Legal Business Name | THERAPY FOR REBELS PLLC
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 5335 W 48TH AVE STE 500
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City | DENVER
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State | CO
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Zip | 80212-2732
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Country | US
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Telephone | 720-689-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 5335 W 48TH AVE STE 500
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City | DENVER
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State | CO
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Zip | 80212-2732
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Country | US
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Telephone | 720-689-8880
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA DISBROW
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Credential | MSW, LSW
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Telephone | 720-689-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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