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1134361009
JOAN E WISE
PUEBLO, CO
NPI
1134361009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO 2935)
Enumeration Date
2009-03-24
Last Update Date
2009-03-24
Business Address
-- JOAN E WISE MA, CAC III
310 W C ST
PUEBLO, CO 81003-3409
Phone number: 719-296-1366
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Mailing Address
-- JOAN E WISE MA, CAC III
310 W C ST
PUEBLO, CO 81003-3409
Phone number: 719-296-1366
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