Individual
DOMINIQUE CONDEVAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, LPC, MAC, NCC
Contact information
Practice address
12101 E 2ND AVE, SUITE 201B, AURORA, CO 80011-8327
(303) 819-7788
(720) 216-0273
Mailing address
12101 E 2ND AVE, SUITE 201B, AURORA, CO 80011-8327
(303) 819-7788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0000219
CO
101YM0800X
Mental Health Counselor
LPC.0011288
CO
Other
Enumeration date
01/12/2011
Last updated
02/14/2017
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