Provider Demographics
NPI:1891317103
Name:INTERNATIONAL AGENTS INCORPORATED
Entity Type:Organization
Organization Name:INTERNATIONAL AGENTS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTING CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUPERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC NBCC
Authorized Official - Phone:970-217-8555
Mailing Address - Street 1:7006 RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-2214
Mailing Address - Country:US
Mailing Address - Phone:970-217-8555
Mailing Address - Fax:970-416-1119
Practice Address - Street 1:19 OLD TOWN SQ
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2471
Practice Address - Country:US
Practice Address - Phone:970-217-8555
Practice Address - Fax:970-416-1119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNATIONAL AGENTS INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty