Individual
HENRY GARRETT MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC II
Contact information
Practice address
811 MAIN CT, CARBONDALE, CO 81623-1851
(970) 704-9292
Mailing address
5351 COUNTY ROAD 100, CARBONDALE, CO 81623-8812
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008228
CO
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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