Individual
JUSTIN P GENOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2429 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 564-5070
Mailing address
96 IRONWEED DR, PUEBLO, CO 81001-1048
(719) 320-3361
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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