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1972226793
JONATHAN MICHAEL PORTILLO
BROOMFIELD, CO
NPI
1972226793
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: CO LPC.0018678)
Enumeration Date
2022-09-26
Last Update Date
2022-09-26
Business Address
Mr. JONATHAN MICHAEL PORTILLO LPC
80 GARDEN CTR STE 48
BROOMFIELD, CO 80020-1777
Phone number: 720-336-0675
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Mailing Address
Mr. JONATHAN MICHAEL PORTILLO LPC
12609 ZUNI ST APT 304
BROOMFIELD, CO 80020-3825
Phone number: 480-206-5524
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