Provider Demographics
NPI:1831316462
Name:BLUMER, DUSTIN ALLEN (BA)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:ALLEN
Last Name:BLUMER
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 S BROADWAY CIR APT 12-207
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-6896
Mailing Address - Country:US
Mailing Address - Phone:303-523-4922
Mailing Address - Fax:
Practice Address - Street 1:6509 S SANTA FE DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2910
Practice Address - Country:US
Practice Address - Phone:303-797-9343
Practice Address - Fax:303-797-9345
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health