ELISSA MARIE MENDIETA

PALMER LAKE, CO
NPI1225884125
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  ACD.0002478)
Enumeration Date2024-04-30
Last Update Date2024-05-13
Business Address
ELISSA MARIE MENDIETA LAC
443 HIGHWAY 105
PALMER LAKE, CO 80133-9003
Phone number: 719-955-1800
Mailing Address
ELISSA MARIE MENDIETA LAC
1610 GATEHOUSE CIR N APT 103
COLORADO SPRINGS, CO 80904-4925
Phone number: 719-930-5812
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