Basic Information
Provider Information
NPI: 1649601584
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUGGER
FirstName: DIANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9233 PARK MEADOWS DR.
Address2: SUITE 207
City: LONE TREE
State: CO
PostalCode: 871093179
CountryCode: US
TelephoneNumber: 5053847352
FaxNumber: 5052747338
Practice Location
Address1: 9233 PARK MEADOWS DR STE 207
Address2:  
City: LONE TREE
State: CO
PostalCode: 80124
CountryCode: US
TelephoneNumber: 5052057500
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/03/2013
LastUpdateDate: 05/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X0162571NMY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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