Individual
MR. DONALD RY MITTLESTADT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
80 GARDEN CTR STE 156, BROOMFIELD, CO 80020-1790
(303) 578-8501
Mailing address
80 GARDEN CTR STE 156, BROOMFIELD, CO 80020-1790
(303) 578-8501
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC13386
CO
Other
Enumeration date
03/20/2013
Last updated
09/24/2018
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