Healthcare Provider Details

I. General information

NPI: 1952823866
Provider Name (Legal Business Name): OLIVIA ROSARIO VALENZUELA NATURAL MEDICINE DR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 N CIRCLE DR STE 6
COLORADO SPRINGS CO
80909-2444
US

IV. Provider business mailing address

1819 N CIRCLE DR STE 6
COLORADO SPRINGS CO
80909-2444
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-3535
  • Fax: 719-329-0382
Mailing address:
  • Phone: 719-471-3535
  • Fax: 719-329-0382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number81004
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: