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General NPI Number Information
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NPI Number | 1326674987
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Entity Type | Individual
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Provider Name | ROBERT BROOKS MAURIO
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Gender | Male
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 03/16/2020
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Provider Practice Location Address
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Address Line | 2600 OAKSHIRE LN
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City | PUEBLO
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State | CO
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Zip | 81001-5671
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Country | US
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Telephone | 719-253-7181
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Fax | 720-723-6024
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Provider Business Mailing Address
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Address Line | 10307 RIFLE FALLS WAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-4488
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Country | US
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Telephone | 719-237-8535
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Fax | 720-723-6024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW-2728
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License Number State | HI
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