Doctor Name: | COLLEEN DAVIS-TIMMS |
NPI Number: | 1538578398 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ACB7798 |
Business Practice Address: | 191 E Agate Ave Granby, CO - 80446 |
Business Phone Number: | 9705316173 |
Business Fax Number: | 9708872293 |
Mailing Address: | Po Box 387, FRASER |
State: | CO |
Postal Code: | 804420387 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | ACB7798 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |