NPI | 1730513912 |
---|---|
Entity Type | Organization |
Authorized Contact | PRUDENCIO A COSYLEON Provider 719-214-0626 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 991432) |
Enumeration Date | 2013-08-24 |
Last Update Date | 2013-08-24 |