| Boundless Potential, LLC | |
|
926 Square Dance Ln Fountain CO 80817-4160 | |
| (325) 338-6182 | |
| Not Available |
| Full Name | Boundless Potential, LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 926 Square Dance Ln, Fountain, Colorado |
| Authorized Official Name and Position | Tiffany Rose Menzel (OWNER) |
| Authorized Official Contact | 3253386182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boundless Potential, LLC 926 Square Dance Ln Fountain CO 80817-4160 Ph: (325) 338-6182 | Boundless Potential, LLC 926 Square Dance Ln Fountain CO 80817-4160 Ph: (325) 338-6182 |
| NPI Number | 1487043980 |
|---|---|
| Provider Enumeration Date | 01/21/2015 |
| Last Update Date | 01/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487043980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 11416922 () | Primary |
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