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Organization

GARY W GOSSAGE LICENSED CLINICAL SOCIAL WORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY W GOSSAGE (OWNER)
(701) 400-2592
Entity
Organization

Contact information

Practice address
1910 PAYTON CIR, COLORADO SPRINGS, CO 80915-1327
(701) 400-2592
(719) 631-0577
Mailing address
1910 PAYTON CIR, COLORADO SPRINGS, CO 80915-1327
(701) 400-2592
(719) 631-0577

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
02/27/2020
Last updated
03/03/2020
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