| Jody Pendleton Psyd, Llc | |
|
2480 High St Canon City CO 81212-8746 | |
| (719) 251-0773 | |
| Not Available |
| Full Name | Jody Pendleton Psyd, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2480 High St, Canon City, Colorado |
| Authorized Official Name and Position | Jody L Pendleton (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7192510773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jody Pendleton Psyd, Llc 2480 High St Canon City CO 81212-8746 Ph: (719) 251-0773 | Jody Pendleton Psyd, Llc 2480 High St Canon City CO 81212-8746 Ph: (719) 251-0773 |
| NPI Number | 1649660184 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 02/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649660184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2859 (Colorado) | Primary |
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