Individual
MRS. SUSAN JO PONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNS/RXN
Contact information
Practice address
1919 65TH AVE STE 3, GREELEY, CO 80634-7965
(970) 590-1138
(970) 356-7437
Mailing address
1919 65TH AVENUE, SUITE 3, INTEGRATION MENTAL HEALTH, GREELEY, CO 80634
(970) 590-1138
(970) 356-7437
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
130627
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134592256
—
CO
01
—
1336496330
COMMERCIAL
CO
Enumeration date
08/08/2012
Last updated
05/31/2021
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