Individual
MRS. CONSTANCE L MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC III
Contact information
Practice address
310 W C ST, PUEBLO, CO 81003-3409
(719) 296-1366
Mailing address
1009 PALMER AVE, PUEBLO, CO 81004-2429
(714) 954-3564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7087
CO
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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