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Individual

MR. LEVON HUPFER-DETOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LAC, MAC

Contact information

Practice address
13611 E 104TH AVE UNIT 700, COMMERCE CITY, CO 80022-8436
(720) 961-8966
Mailing address
13611 E 104TH AVE UNIT 700, COMMERCE CITY, CO 80022-8436
(720) 961-8966

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
126891
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
216
CO

Other

Enumeration date
03/23/2017
Last updated
02/27/2020
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