Individual
BRIAN A GOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC II
Contact information
Practice address
2217 CHAMPA ST, DENVER, CO 80205-2531
(720) 398-9666
Mailing address
2217 CHAMPA ST, DENVER, CO 80205-2531
(720) 398-9666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008346
CO
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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