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Individual

DAWAUNE LATIEFTH ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2323 S TROY ST, AURORA, CO 80014-1946
(720) 882-2421
(720) 882-2421
Mailing address
2323 S TROY ST STE 209, AURORA, CO 80014-1946
(303) 671-2480
(303) 671-2480

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TC1900X
Counseling Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
920653694
CO
Enumeration date
06/19/2017
Last updated
08/09/2022
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