Individual
MICHAEL JAY TOOTHAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACIII
Contact information
Practice address
320 OAK ST., STEAMBOAT, CO 80477
(970) 761-2207
Mailing address
PO BOX 773705, STEAMBOAT SPRINGS, CO 80477-3705
(970) 761-2207
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2662
CO
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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