Individual
GREG CARBAJAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1625 GAYLORD AVE, PUEBLO, CO 81004-2660
(719) 821-7274
Mailing address
509 E. 13TH STREET, PUEBLO, CO 81001
(719) 546-6666
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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