Individual
MR. JOHN ROBERT DIMATTEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW,LCSW
Contact information
Practice address
1304 CHINOOK LN, PUEBLO, CO 81001-1851
(719) 545-2746
(719) 584-0110
Mailing address
63 E PARKRIDGE DR, PUEBLO WEST, CO 81007-1377
(719) 547-3263
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
692
CO
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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