Individual
IVONNE GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
113 W 12TH ST, PUEBLO, CO 81003-2808
(719) 568-1232
Mailing address
1707 GARWOOD DR, PUEBLO, CO 81005-2240
(719) 334-2274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LSW.0009924867
CO
1041C0700X
Clinical Social Worker
Primary
LSW.0009924867
CO
Other
Enumeration date
09/04/2023
Last updated
09/18/2023
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