PRUDENCIO COSYLEON

PUEBLO, CO
NPI1083775498
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CO  991432)
Enumeration Date2006-12-12
Last Update Date2016-03-14
Business Address
-- PRUDENCIO COSYLEON LCSW
417 W 13TH ST
PUEBLO, CO 81003-2703
Phone number: 719-544-0877
Mailing Address
-- PRUDENCIO COSYLEON LCSW
110 E ROUTT AVE
PUEBLO, CO 81004-2117
Phone number: 719-543-8711
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