| NPI | 1124872809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNER HALL Credentialing Specialist 719-428-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician | |
| 225100000X Physical Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |