| NPI | 1356020564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND DOTSON Billing Manager 970-576-1717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2023-07-14 |