Provider Demographics
NPI:1902564255
Name:DANA, CHARLES BRYCE
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:BRYCE
Last Name:DANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2876 DEER CREEK PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-4362
Mailing Address - Country:US
Mailing Address - Phone:303-502-4891
Mailing Address - Fax:
Practice Address - Street 1:2876 DEER CREEK PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-4362
Practice Address - Country:US
Practice Address - Phone:303-502-4891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor