Individual
CEDRA D ETESAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
15682 STATE HIGHWAY 172 LOT 34, IGNACIO, CO 81137-9742
(970) 426-9591
Mailing address
15682 STATE HIGHWAY 172 LOT 34, IGNACIO, CO 81137-9742
(970) 426-9591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0009925857
CO
Other
Enumeration date
12/23/2022
Last updated
04/22/2025
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