Optum Behavioral Care of Colorado, P.c.

NPI #1104688365 in Fond Du Lac, Wisconsin

Provider Information

NPI Number: 1104688365
Entity Type: Organization
Organization Name: Optum Behavioral Care of Colorado, P.c.
Primary Specialty: Psychologist - Counseling
Enumeration Date: Jan 24, 2024
Last Updated: Apr 24, 2024

Practice Location

Address: 196 3RD ST
City: Fond Du Lac
State: Wisconsin
ZIP Code: 54935-4418
Phone: (920) 733-2065

Authorized Official

Name: LESLIE JOHNSON
Title: CEO
Phone: (704) 506-6267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Counseling — Counseling	103TC1900X	Primary

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