| NPI | 1427606136 |
|---|---|
| Former Legal Business Name | THE DAWN GODDESS LLC |
| Entity Type | Organization |
| Authorized Contact | AMIESSA DAWN JUTTEN Owner 970-465-2714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |