Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003277658 |
---|---|
Provider Name | Carol Gurule |
First Address | Alamosa, CO 81101-9610 |
Second Address | Alamosa, CO 81101-9610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2016 |
Last Update Date | 10/03/2016 |