Individual
GWENDOLYN MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1591 TAOS RD, PUEBLO, CO 81006-1232
(719) 545-2746
Mailing address
41 MONTEBELLO RD STE 204, PUEBLO, CO 81001-1379
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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