Provider Demographics
NPI:1649946534
Name:KITTREDGE, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KITTREDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5708
Mailing Address - Country:US
Mailing Address - Phone:847-259-4073
Mailing Address - Fax:
Practice Address - Street 1:155 W HARVARD ST STE 401
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5200
Practice Address - Country:US
Practice Address - Phone:970-672-7974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health