| NPI | 1003355801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA TANAKA Owner 719-588-6578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 5724) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 5724) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |