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General NPI Number Information
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NPI Number | 1497810477
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Entity Type | Organization
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Legal Business Name | WELLNESS COUNSELING CENTER
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 301 N MAIN ST STE 110
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City | PUEBLO
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State | CO
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Zip | 81003-3257
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Country | US
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Telephone | 719-547-3829
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Fax | 719-546-1942
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Provider Business Mailing Address
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Address Line | 301 N MAIN ST STE 110
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City | PUEBLO
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State | CO
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Zip | 81003-3257
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Country | US
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Telephone | 719-547-3829
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Fax | 719-546-1942
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | SYLVIA ORLINDA MAREZ-FRANSUA
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Credential | MSW
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Telephone | 719-547-3829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 989669
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License Number State | CO
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