| NPI | 1114412111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY R LOPEZ Owner 719-371-2212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 9924482) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-06-22 |