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General NPI Number Information
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NPI Number | 1992230353
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Entity Type | Organization
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Legal Business Name | W GROUP
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 609 W LITTLETON BLVD SUITE 309
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City | LITTLETON
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State | CO
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Zip | 80120-2368
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Country | US
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Telephone | 702-295-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 5648 S SPOTSWOOD ST
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City | LITTLETON
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State | CO
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Zip | 80120-1215
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Country | US
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Telephone | 303-794-3816
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | WHITNEY DITTMAR
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Credential | MA, LPC
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Telephone | 303-794-3816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0005644
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License Number State | CO
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