Individual
CAROLINE IVETTE WENDICHANSKY BRODSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4720 GALLEY RD, COLORADO SPRINGS, CO 80915-2735
(719) 422-7691
Mailing address
PO BOX 518, CANON CITY, CO 81215-0518
(719) 582-3267
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0106797
CO
101YM0800X
Mental Health Counselor
0106797
CO
103T00000X
Psychologist
00013891
CO
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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