| NPI | 1104069335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN M BROUSSEAU President, Sole Proprietor 720-938-6720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 40799) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-28 |