Individual
ESSANCE SADE' CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6050 ERIN PARK DR, COLORADO SPRINGS, CO 80918-3488
(719) 375-9896
Mailing address
6050 ERIN PARK DR, COLORADO SPRINGS, CO 80918-3488
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437321189
—
CO
Enumeration date
01/08/2019
Last updated
01/08/2019
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