JONATHAN L FAGERHOLM

COLORADO SPRINGS, CO
NPI1568975076
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  NLC.0105760)
Enumeration Date2017-11-07
Last Update Date2017-11-07
Business Address
JONATHAN L FAGERHOLM
112 IOWA AVE STE 4
COLORADO SPRINGS, CO 80909-5947
Phone number: 719-358-7228
Mailing Address
JONATHAN L FAGERHOLM
112 IOWA AVE STE 4
COLORADO SPRINGS, CO 80909-5947
Phone number: 719-358-7228
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