| NPI | 1255710414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY GOLLICK Clinician 303-520-8096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012290) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |