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Individual

VICTORIA CANNELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4570 HILTON PKWY STE 202D, COLORADO SPRINGS, CO 80907-3566
(719) 432-9222
Mailing address
5543 WOODMEN RIDGE VW APT 302, COLORADO SPRINGS, CO 80923-5201
(719) 338-2403

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NLC.0109386
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
936956
CO
Enumeration date
03/29/2019
Last updated
03/29/2019
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