| NPI | 1225267503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLECKLER Licensed Psychologist 719-466-9645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 3216) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |