| NPI | 1134711641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE TAGLIAFERRO Administrative Assistant 719-955-7008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |