| Soul Shine, LLC | |
|
1800 30th St Ste 207 Boulder CO 80301-1026 | |
| (720) 460-7224 | |
| Not Available |
| Full Name | Soul Shine, LLC |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1800 30th St Ste 207, Boulder, Colorado |
| Authorized Official Name and Position | Gretchen Stecher (OWNER) |
| Authorized Official Contact | 7204607224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Shine, LLC 455 N Burlington Ave Unit 224 Lafayette CO 80026-2509 Ph: (720) 460-7224 | Soul Shine, LLC 1800 30th St Ste 207 Boulder CO 80301-1026 Ph: (720) 460-7224 |
| NPI Number | 1043839947 |
|---|---|
| Provider Enumeration Date | 04/10/2020 |
| Last Update Date | 04/10/2020 |
| Certification Date | 04/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043839947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
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