| Dawn Glenn | |
|
169 N Willow St Fruita CO 81521-2526 | |
| (970) 296-4757 | |
| (970) 360-1134 |
| Full Name | Dawn Glenn |
|---|---|
| Speciality | Counselor |
| Location | 169 N Willow St, Fruita, Colorado |
| Authorized Official Name and Position | Dawn Marie Glenn (COUNSELOR) |
| Authorized Official Contact | 9702964757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dawn Glenn 169 N Willow St Fruita CO 81521-2526 Ph: (970) 296-4757 | Dawn Glenn 169 N Willow St Fruita CO 81521-2526 Ph: (970) 296-4757 |
| NPI Number | 1326728346 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Certification Date | 07/24/2023 |
| Medicare PECOS PAC ID | 0446698625 |
|---|---|
| Medicare Enrollment ID | O20240408000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326728346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Dawn Marie Glenn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477860039 PECOS PAC ID: 1355789538 Enrollment ID: I20240408000189 |
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