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Individual

MR. LARRY LAMARR GADSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAC III

Contact information

Practice address
1880 DUBLIN BLVD SUITE B, COLORADO SPRINGS, CO 80918
(719) 599-0047
Mailing address
1880 DUBLIN BLVD SUITE B, COLORADO SPRINGS, CO 80918
(719) 599-0047
(719) 599-0913

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1435-00
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACC0007258
CERIFY ADDICTION COUNS
CO
Enumeration date
01/21/2014
Last updated
01/21/2014
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