Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ACB.0007982 | CO |
NPI | 1003383605 |
---|---|
Provider Name | Darrin Miller |
First Address | Lakewood, CO 80228-2041 |
Second Address | Lakewood, CO 80228-2041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2018 |
Last Update Date | 01/11/2018 |