| NPI | 1184393738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA HONN QUALLS Clinical Psychologist 719-428-5025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-09-08 |