MR. Edgar Carl De Van III, CAC II

NPI #1215139019 in Walsenburg, Colorado

Provider Information

NPI Number
1215139019
Entity Type
Individual
Name
MR. Edgar Carl De Van III, CAC II
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
CAC II
Enumeration Date
Jun 4, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
615 RUSSELL AVE
ZIP Code
81089-2127
Phone
(719) 738-2076

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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