| NPI | 1093168650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE ANNE WATSON Therapist 719-963-5744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0012495) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-12-12 |