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1407330368
JUSTIN P GENOVA
PUEBLO, CO
NPI
1407330368
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-09-17
Last Update Date
2018-09-17
Business Address
JUSTIN P GENOVA
2429 S PRAIRIE AVE
PUEBLO, CO 81005-2886
Phone number: 719-564-5070
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Mailing Address
JUSTIN P GENOVA
96 IRONWEED DR
PUEBLO, CO 81001-1048
Phone number: 719-320-3361
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