Individual
STEVEN RALPH COLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT22969
CA
Other
Enumeration date
11/20/2008
Last updated
11/04/2011
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