NPI 1003302902

Jaycob Gonzales-Cordova

Practitioner Counselor Pueblo, CO

Practice location

Address: 1302 Chinook Ln, Pueblo, CO 81001-1851
Phone: (719) 545-2746
Fax: (719) 423-1882
Mailing address: 41 Montebello Rd STE 202, Pueblo, CO 81001-1366

Registered specialties

Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101Y00000X

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Registry record

NPI: 1003302902
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jul 2018
Record last updated: 3 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.