Individual
JOSE L ELIZALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
50 BUCK CREEK RD #200, AVON, CO 81620
(970) 926-6340
Mailing address
50 BUCK CREEK RD #200, AVON, CO 81620
(970) 926-6340
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
CSW.09924773
CO
Other
Enumeration date
09/07/2011
Last updated
12/16/2019
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