Individual
IMELDA BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOTHERAPIST
Contact information
Practice address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 546-6666
(719) 543-7764
Mailing address
1443 CORONADO DR, COLORADO SPRINGS, CO 80910-1932
(719) 213-0482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/23/2010
Last updated
12/01/2010
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