Individual
MR. LEVI THOMAS MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
327 COLORADO AVE, PUEBLO, CO 81004-2005
(719) 251-4645
Mailing address
327 COLORADO AVE, PUEBLO, CO 81004-2005
(719) 251-4645
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6477
CO
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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