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General NPI Number Information
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NPI Number | 1285406835
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Entity Type | Organization
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Legal Business Name | SEDILLO PSYCHIATRIC WELLNESS RESEARCH CONSULTING LLC
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 110 S PARKSIDE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3129
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Country | US
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Telephone | 719-351-5663
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Fax |
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Provider Business Mailing Address
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Address Line | 17535 W CHERRY STAGE RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-3423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW SEDILLO
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Credential |
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Telephone | 719-619-7924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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