Individual
CARMEN L IACINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAC
Contact information
Practice address
812 GRAND AVE STE 207, GLENWOOD SPRINGS, CO 81601-3478
(970) 309-3779
Mailing address
812 GRAND AVE STE 207, GLENWOOD SPRINGS, CO 81601-3478
(970) 309-3779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
002
CO
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/07/2007
Last updated
09/06/2019
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