Individual
MR. MARK ANTHONY SALAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAS
Contact information
Practice address
275 W ABRIENDO AVE, PUEBLO, CO 81004-1870
(719) 621-1929
Mailing address
275 W ABRIENDO AVE, PUEBLO, CO 81004-1870
(719) 621-1929
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0997499
CO
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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