| NPI | 1194428268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYRETTA MCGRAW Owner/Nurse Practitioner 719-412-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-06-05 |