Organization
CHILDREN'S SPECIALTY CLINIC OF SAN LUIS VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L CLUTTER (CHIEF OF OPERATIONS)
(719) 852-3742
Entity
Organization
Contact information
Practice address
10 RUPERT ST, MONTE VISTA, CO 81144-1042
(719) 852-3742
Mailing address
10 RUPERT ST, MONTE VISTA, CO 81144-1042
(719) 852-3742
(719) 852-2559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/07/2024
Last updated
02/06/2026
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