NPI | 1194331215 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACIE A NICOLL Clinical Psychologist 719-247-3561 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2020-09-23 |
Last Update Date | 2024-12-09 |