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Individual

JENNIFER LYNN BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5353 N UNION BLVD STE 201A, COLORADO SPRINGS, CO 80918-2069
(719) 401-1822
Mailing address
17035 BLUE MIST GRV, MONUMENT, CO 80132-8639
(719) 401-1822

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/03/2023
Last updated
08/03/2023
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