Individual
MARILYN GAY CROWTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 MAIN STREET, LA JARA, CO 81140
(719) 992-4260
Mailing address
14385 COUNTY ROAD P, LA JARA, CO 81140-9584
(719) 992-4260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6464
CO
Other
Enumeration date
06/05/2007
Last updated
05/04/2017
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