| NPI | 1447039284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND DOTSON Billing And Credentialing Manager 970-576-1717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |