| NPI | 1184436388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND DOTSON Billing And Credentialing Manager 970-576-1717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-23 |