Individual
AMAYA LEE CHARBONEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 W 29TH ST APT 300, PUEBLO, CO 81008-1159
(719) 406-7988
Mailing address
1817 E 17TH ST, PUEBLO, CO 81001-2712
(719) 406-7988
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0025236
CO
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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