ALEXANDER MEDINA

PUEBLO, CO
NPI1588413959
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  ACC.0021158)
Enumeration Date2024-05-16
Last Update Date2024-06-10
Business Address
ALEXANDER MEDINA CAS. BS.
509 E 13TH ST
PUEBLO, CO 81001-2940
Phone number: 719-546-6667
Mailing Address
ALEXANDER MEDINA CAS. BS.
3112 ASTER ST
PUEBLO, CO 81005-3179
Phone number: 719-553-7172
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