Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1083984892 |
---|---|
Provider Name | Mr. Dennis John Middel |
First Address | Denver, CO 80222-6012 |
Second Address | Denver, CO 80222-6012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 10/01/2012 |