| NPI | 1164690186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA J MARSHALL Provider 719-406-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 1394) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2022-03-21 |