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General NPI Number Information
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NPI Number | 1629854930
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Entity Type | Organization
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Legal Business Name | REYNEL MIRABAL
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 5525 ERINDALE DR STE 201
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6962
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Country | US
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Telephone | 305-773-7927
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Fax |
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Provider Business Mailing Address
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Address Line | 3670 QUEEN ANNE WAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-5491
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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 | THERAPIST
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Name | REYNEL MIRABAL
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Credential | LCSW
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Telephone | 305-773-7927
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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 |
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License Number State |
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