Individual
MR. KEITH DE'MEL PONTIFLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC III
Contact information
Practice address
14231 E 4TH AVE STE 370, BLUDING 1, AURORA, CO 80011-8720
(303) 856-3485
Mailing address
14221 E 1ST DR, #201, AURORA, CO 80011-3811
(720) 327-8821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC0006578
CO
101YM0800X
Mental Health Counselor
ACC0006578
CO
Other
Enumeration date
02/21/2007
Last updated
07/21/2022
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