MEDICARE: REBECCA TEMPLE

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	106H00000X	Marriage & Family Therapist	NLC.0105544	CO

General Provider Information

NPI Number	:	1760927180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA TEMPLE

Provider Business Mailing Address
First Line	:	1516 LAKE VISTA WAY
Second Line	:
City	:	SEVERANCE
State	:	CO
Zip	:	80550-3804
Country	:	US
Telephone Number	:	970-541-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	760 WHALERS WAY STE 100
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3370
Country	:	US
Telephone Number	:	970-541-1116
Fax Number	:

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

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	06/28/2024

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Directions to “ REBECCA TEMPLE ” Practice Location

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