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Individual

MR. W DOUGLAS BAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPC, CAC III

Contact information

Practice address
619 MAIN ST, FRISCO, CO 80443
(970) 668-3996
Mailing address
PO BOX 4325, FRISCO, CO 80443-4325
(970) 668-3996

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1039
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1039
LPC
CO
01
1461
CAC III
CO
Enumeration date
10/28/2006
Last updated
07/08/2007
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