Individual
MARY JOY KOGOVSEK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 546-6666
(719) 546-8273
Mailing address
2133 SPRUCE ST, PUEBLO, CO 81004-3731
(719) 546-6666
(719) 546-8273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
840
CO
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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