Provider Demographics
NPI:1760972145
Name:HUEMMLER, JOHANNA LOPEZ (LMFT)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:LOPEZ
Last Name:HUEMMLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:FIGUEROA
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2212 VERMONT DR APT B204
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6644
Mailing Address - Country:US
Mailing Address - Phone:303-522-8879
Mailing Address - Fax:
Practice Address - Street 1:2625 REDWING RD STE 175
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6324
Practice Address - Country:US
Practice Address - Phone:970-795-2825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist