Individual
BARBARA RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41 MONTEBELLO RD, SET LL1, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 543-7104
Mailing address
41 MONTEBELLO RD, SUITE 200, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 542-9638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACB.0007986
CO
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2016
Last updated
02/16/2017
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