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1639940877
JACK SAMUEL VALDEZ
PUEBLO, CO
NPI
1639940877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CO 9923486)
Enumeration Date
2024-01-15
Last Update Date
2024-01-15
Business Address
JACK SAMUEL VALDEZ
114 BRIDLE TRL
PUEBLO, CO 81005-3031
Phone number: 719-406-1958
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Mailing Address
JACK SAMUEL VALDEZ
114 BRIDLE TRL
PUEBLO, CO 81005-3031
Phone number: 719-406-1958
Copy
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