| NPI | 1316636236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE WILSON Owner 719-493-8843 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |