| NPI | 1184824872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE GILLICK President Psychologist 719-201-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2883) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |