is a Mental Health in Pueblo, Colorado. practices all healthcare services and medical treatments related to Mental Health. The NPI Number for is 1538379466. The last update date is .
's current location address is 1012 Walnutcrest Dr, Pueblo, Colorado. You can contact this provider via phone number 7194041130 and fax number 7195447705. The mailing address for is 1012 Walnutcrest Dr, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1012 Walnutcrest Dr, Pueblo, Colorado |
| Phone Number | 7194041130 |
| Fax Number | 7195447705 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1538379466 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1012 Walnutcrest Dr |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810055561 |
| Phone Number | 7194041130 |
| Fax Number | 7195447705 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | LPC-2033 |
|
Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 88805280 | CO | -- |
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