Individual
DR. GLADYS RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2115 STUART AVE, SLV REGIONAL MEDICAL CENTER, ALAMOSA, CO 81101-2269
(719) 589-8008
(719) 589-8012
Mailing address
106 BLANCA AVE, SLV REGIONAL MEDICAL CENTER, ALAMOSA, CO 81101-2340
(719) 589-8008
(719) 589-8012
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2005-0427
NM
2084P0800X
Psychiatry Physician
Primary
31021
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310218
—
CO
Enumeration date
02/06/2007
Last updated
06/04/2009
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