| NPI | 1205322666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIRDRE SULLIVAN Executive Director 970-221-1615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 225X00000X Occupational Therapist | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-12-12 |