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Provider Information for 1205231727


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JOVENS COLAS LSW


Sex: Male

NPI: 1205231727
Last Updated: 2014-10-27
Certification Date:

Details

NameValue
NPI1205231727
Enumeration Date2014-10-27
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 7219 N LITCHFIELD RD
GLENDALE, AZ 85309-1529
United States

Phone: 623-856-4181 | Fax:623-856-4433
 
Primary Practice Address 7219 N LITCHFIELD RD
GLENDALE, AZ 85309-1529
United States

Phone: 623-856-4181 | Fax:623-856-4433
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker NJ44SL06002600