Individual
GLADYS VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
31481 UPPER BEAR CREEK RD, EVERGREEN, CO 80439-7818
(559) 307-1800
Mailing address
31481 UPPER BEAR CREEK RD, EVERGREEN, CO 80439-7818
(559) 307-1800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09924043
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97720062
—
CO
Enumeration date
02/03/2015
Last updated
10/18/2021
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