Individual
SUZETTE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W 24TH ST STE 2, PUEBLO, CO 81003-2471
(719) 320-1729
Mailing address
311 W 24TH ST STE 2, PUEBLO, CO 81003-2471
(719) 320-1729
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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