| NPI | 1639906407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND DOTSON Billing Manager 970-576-1717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |