Individual
TRACIE PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAS
Contact information
Practice address
275 W ABRIENDO AVE, PUEBLO, CO 81004-1870
(719) 621-1929
(719) 621-4974
Mailing address
275 W ABRIENDO AVE, PUEBLO, CO 81004-1870
(719) 621-1929
(719) 621-4974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0997155
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ACC.0997155
CAS
CO
Enumeration date
06/04/2022
Last updated
06/04/2022
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