Individual
MRS. PRISCILLA LEE AGOSTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
101YA0400X
Contact information
Practice address
724 N TEJON ST, COLORADO SPRINGS, CO 80903-1012
(719) 227-7745
Mailing address
724 N TEJON ST, COLORADO SPRINGS, CO 80903-1012
(719) 227-7745
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003871328
—
CO
Enumeration date
02/14/2020
Last updated
02/14/2020
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