Provider Demographics
NPI:1326728346
Name:DAWN GLENN
Entity Type:Organization
Organization Name:DAWN GLENN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-296-4757
Mailing Address - Street 1:169 N WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-2526
Mailing Address - Country:US
Mailing Address - Phone:970-296-4757
Mailing Address - Fax:970-360-1134
Practice Address - Street 1:169 N WILLOW ST
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2526
Practice Address - Country:US
Practice Address - Phone:970-296-4757
Practice Address - Fax:970-360-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty