Provider Information for 1942593538
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WINGS OF HOPE COUNSELING SERVICES, PLLC
Organization Subpart: NO
NPI: 1942593538
Last Updated: 2011-05-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1942593538 | ||||||||||||
| Enumeration Date | 2011-05-16 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: Ms. TIMOTHY R PEARSON LPC ; CAC III Title: Director Phone: 7192758714 | ||||||||||||
| Mailing Address | PO BOX 521 CANON CITY, CO 81215-0521 United States Phone: 877-582-7839 | Fax:877-582-7839 | ||||||||||||
| Primary Practice Address | 1335 PHAY AVE CANON CITY, CO 81212-2334 United States Phone: 877-582-7839 | Fax:877-562-7839 | ||||||||||||
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