Provider Demographics
NPI:1831587732
Name:RIEN, DAWN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:RIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PENROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81240-9014
Mailing Address - Country:US
Mailing Address - Phone:207-841-2889
Mailing Address - Fax:
Practice Address - Street 1:533 11TH ST
Practice Address - Street 2:
Practice Address - City:PENROSE
Practice Address - State:CO
Practice Address - Zip Code:81240-9014
Practice Address - Country:US
Practice Address - Phone:207-841-2889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7236101YA0400X
CO104632101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)