Individual
KANDY KAY HERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 N MAIN ST STE 240, PUEBLO, CO 81003-3046
(719) 569-1909
Mailing address
720 N MAIN ST STE 240, PUEBLO, CO 81003-3046
(719) 569-1909
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0007560
CO
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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