| Turquoise Trail Therapy Llc | |
|
1191 Canon Ridge Rd Canon City CO 81212-9163 | |
| (719) 276-2550 | |
| Not Available |
| Full Name | Turquoise Trail Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1191 Canon Ridge Rd, Canon City, Colorado |
| Authorized Official Name and Position | Mary Anna Shorter-king (MANAGING MEMBER) |
| Authorized Official Contact | 7192762550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Turquoise Trail Therapy Llc 1191 Canon Ridge Rd Canon City CO 81212-9163 Ph: (719) 276-2550 | Turquoise Trail Therapy Llc 1191 Canon Ridge Rd Canon City CO 81212-9163 Ph: (719) 276-2550 |
| NPI Number | 1124725130 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124725130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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