Individual
MR. GEORGE W. SCUDELLA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
615 N 15TH ST, CANON CITY, CO 81212-2313
(719) 269-8338
(719) 269-9170
Mailing address
615 N 15TH ST, CANON CITY, CO 81212-2313
(719) 269-8338
(719) 269-9170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
989952
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07989957
—
CO
Enumeration date
03/21/2006
Last updated
07/08/2007
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