Individual
ALAN DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC II
Contact information
Practice address
602 YALE PL, CANON CITY, CO 81212-4611
(719) 275-0700
Mailing address
602 YALE PL, CANON CITY, CO 81212-4611
(719) 275-0700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0008217
CO
101YM0800X
Mental Health Counselor
0106063
CO
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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