Individual
BRIANNA C BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 545-2746
(719) 583-4160
Mailing address
41 MONTEBELLO RD, SUITE 200, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 542-9638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000451
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09923877
CO
Other
Enumeration date
04/02/2013
Last updated
02/16/2017
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