| NPI | 1023745213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICENA FONTAINE Owner 970-646-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-08-06 |
| Last Update Date | 2024-02-01 |