Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 107558 | CO |
NPI | 1003587825 |
---|---|
Provider Name | Dawn Mockler |
First Address | Salida, CO 81201-9327 |
Second Address | Salida, CO 81201-9327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2021 |
Last Update Date | 22/09/2021 |