| NPI | 1114104163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM S LUNDGREN Owner 303-329-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3169) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS006144L) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |