Organization
JDL & MAKL LLC
Active
Other names
Chipita Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN K. LONGWELL (SECRETARY)
(719) 329-4810
Entity
Organization
Contact information
Practice address
1548 G ST UNIT 2A, SALIDA, CO 81201-2651
(719) 329-4810
(866) 805-1874
Mailing address
PO BOX 627, 1133 E. OURAY AVE, PONCHA SPRINGS, CO 81242-0627
(719) 329-4810
(866) 805-1874
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1159
CO
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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