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Individual

REBECCA LYNN GARDOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MATVI, CLVT, COMS

Contact information

Practice address
4505 S PAGOSA CIR, AURORA, CO 80015-1920
(928) 245-3164
Mailing address
4505 S PAGOSA CIR, AURORA, CO 80015-1920

Taxonomy

Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
5781
AZ
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
22576
AZ

Other

Enumeration date
08/10/2023
Last updated
08/10/2023
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