| Kimberly Ditzler | |
|
665 Pinyon Dr Fruita CO 81521-6405 | |
| (970) 623-4216 | |
| (970) 549-1400 |
| Full Name | Kimberly Ditzler |
|---|---|
| Speciality | Counselor - Professional |
| Location | 665 Pinyon Dr, Fruita, Colorado |
| Authorized Official Name and Position | Kimberly Potter (LPC) |
| Authorized Official Contact | 9706234216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Ditzler Po Box 264 Fruita CO 81521-0264 Ph: (970) 623-4216 | Kimberly Ditzler 665 Pinyon Dr Fruita CO 81521-6405 Ph: (970) 623-4216 |
| NPI Number | 1972150415 |
|---|---|
| Provider Enumeration Date | 08/20/2019 |
| Last Update Date | 08/05/2026 |
| Certification Date | 08/05/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972150415 | NPI | - | NPPES |
| 0014854 | Other | CO | LPC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Primary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
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