Boulder Alcohol Education Center INC

NPI #1992345458 in Boulder, Colorado

Provider Information

NPI Number: 1992345458
Entity Type: Organization
Organization Name: Boulder Alcohol Education Center INC
Primary Specialty: Psychologist - Addiction (Substance Use Disorder)
Enumeration Date: Jan 13, 2020
Last Updated: Jan 13, 2020

Practice Location

Address: 1525 SPRUCE ST STE 100
City: Boulder
State: Colorado
ZIP Code: 80302-4256
Phone: (303) 444-6142

Authorized Official

Name: JOHN O GILBURT, PHD, CAC III, LPSY
Title: OWNER/DIRECTOR
Phone: (720) 235-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	103TA0400X	Primary

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