Individual
TIMOTHY P O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA.,CAC I I
Contact information
Practice address
3065 MT. HERMAN RD., MONUMENT, CO 80132
(719) 322-7175
Mailing address
3065 MOUNT HERMAN RD, MONUMENT, CO 80132-8196
(719) 322-7175
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008017
CO
Other
Enumeration date
11/10/2014
Last updated
02/02/2017
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