Provider Demographics
NPI:1780781849
Name:RICE, ILENE (LMFT)
Entity type:Individual
Prefix:
First Name:ILENE
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19710 SOARING WING DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2307
Mailing Address - Country:US
Mailing Address - Phone:719-331-3447
Mailing Address - Fax:719-481-8595
Practice Address - Street 1:1880 DUBLIN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1293
Practice Address - Country:US
Practice Address - Phone:719-331-3447
Practice Address - Fax:719-481-8595
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist