is a Mental Health in Pueblo, Colorado. practices all healthcare services and medical treatments related to Mental Health. The NPI Number for is 1740490762. The last update date is .
's current location address is 1715 Crestmoor Dr, Pueblo, Colorado. You can contact this provider via phone number 7194041130 and fax number 7195447705. The mailing address for is 1715 Crestmoor Dr, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1715 Crestmoor Dr, Pueblo, Colorado |
| Phone Number | 7194041130 |
| Fax Number | 7195447705 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1740490762 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1715 Crestmoor Dr |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810012729 |
| Phone Number | 7194041130 |
| Fax Number | 7195447705 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | LPC-1272 |
|
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 |
|---|---|---|---|
| 20775881 | CO | -- |
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