Individual
PENNY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACIII
Contact information
Practice address
421 N MAIN ST, SUITE 214, PUEBLO, CO 81003-3196
(719) 214-3033
Mailing address
421 N MAIN ST, SUITE 214, PUEBLO, CO 81003-3196
(719) 214-3033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1544
CO
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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