| NPI | 1134572464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES J DO Practice Manager 719-422-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013085) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LPC.0013085) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2021-05-07 |