Individual
MIRIAM ENID DEDOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2429 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 564-5070
(719) 896-2874
Mailing address
2429 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 564-5070
(719) 896-2874
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CO
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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