Individual
MAC DVORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3966 COSTILLO CT, BRIGHTON, CO 80601-6562
(856) 562-8092
Mailing address
3966 COSTILLO CT, BRIGHTON, CO 80601-6562
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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