Individual
TYLEEN IRENE SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2429 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 564-5070
(719) 896-2874
Mailing address
2429 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 564-5070
(719) 896-2874
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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