| NPI | 1144719055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE GUERRA Owner/Provider 719-332-7794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013058) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2021-05-11 |