DWAN NICOLE GOODRICH

PUEBLO, CO
NPI1861795668
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  6530)
Enumeration Date2010-12-16
Last Update Date2010-12-16
Business Address
-- DWAN NICOLE GOODRICH BS CAC I
3500 BALTIMORE AVE
PUEBLO, CO 81008-1543
Phone number: 719-545-1181
Mailing Address
-- DWAN NICOLE GOODRICH BS CAC I
3500 BALTIMORE AVE
PUEBLO, CO 81008-1543
Phone number: 719-545-1181