| NPI | 1710680368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND DOTSON Billing And Credentialing Manager 970-576-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2025-12-25 |