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General NPI Number Information
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NPI Number | 1851946099
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Entity Type | Organization
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Legal Business Name | SOUL DOGS INC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 5005 W 81ST PL UNIT 200
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City | WESTMINSTER
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State | CO
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Zip | 80031-4380
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Country | US
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Telephone | 303-250-2785
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Fax |
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Provider Business Mailing Address
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Address Line | 5005 W 81ST PL UNIT 200
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City | WESTMINSTER
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State | CO
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Zip | 80031-4380
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Country | US
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Telephone | 303-250-2785
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. CHRISTIAN ANDERSON
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Credential | PHD ACSW LCSW CCTS
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Telephone | 303-250-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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