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Individual

SUSAN LEIGH SANDOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.A.T.

Contact information

Practice address
451 14TH ST, BURLINGTON, CO 80807-1609
(719) 297-1818
Mailing address
2485 TOWER AVE, BURLINGTON, CO 80807-2613
(719) 342-0586

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACA.0008128
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACC.0021272
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC01832
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACC.0021272
COLORADO DEPARTMENT OF REGULATORY AGENCIES
CO
01
LAC01832
KANSAS BEHAVIORAL SCIENCES REGULATORY BOARD
KS
Enumeration date
02/04/2022
Last updated
03/21/2023
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