MEDICARE: JENNIFER LIN MEYER M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LPC-13013	CO

General Provider Information

NPI Number	:	1548812142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LIN MEYER M.A.

Provider Business Mailing Address
First Line	:	3645 MAIN ST
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-2282
Country	:	US
Telephone Number	:	970-689-2247
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 AUTOMATION WAY UNIT D3
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3448
Country	:	US
Telephone Number	:	970-689-2247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	07/12/2019

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