Individual
DYLAN SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3960 IVYWOOD LN, PUEBLO, CO 81005-2567
(719) 565-1276
(719) 565-2313
Mailing address
3960 IVYWOOD LN, PUEBLO, CO 81005-2567
(719) 565-1276
(719) 565-2313
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21-150544
CO
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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