Organization
LARA RISTOW LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARA RISTOW LCSW (OWNER)
(970) 946-2669
Entity
Organization
Contact information
Practice address
2855 MAIN AVE STE A104, DURANGO, CO 81301-5959
(970) 946-2669
Mailing address
245 VALLEY VIEW CIR, DURANGO, CO 81301-4298
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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