Individual
LARA C RISTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2855 MAIN AVE STE A104, DURANGO, CO 81301-5959
(970) 946-2669
Mailing address
245 VALLEY VIEW CIR, DURANGO, CO 81301-4298
(970) 946-2669
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1286
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18858562
—
CO
Enumeration date
08/02/2009
Last updated
09/08/2021
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