Individual
DENNISHA BERNELL LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
3500 1ST STREET SOUTH, LAMAR, CO 81052
(719) 336-7501
(719) 336-7453
Mailing address
1705 S 13TH ST, LAMAR, CO 81052-4015
(719) 336-0828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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