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1932819083
SCOTT GALE LANE
PUEBLO, CO
NPI
1932819083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO ACC.0004528)
Enumeration Date
2022-11-30
Last Update Date
2022-11-30
Business Address
SCOTT GALE LANE
3500 BALTIMORE AVE
PUEBLO, CO 81008-1543
Phone number: 719-545-1181
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Mailing Address
SCOTT GALE LANE
3500 BALTIMORE AVE
PUEBLO, CO 81008-1543
Phone number: 719-545-1181
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