| NPI | 1336957901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW BLUBAUGH Office Manager 719-679-5022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2025-10-03 |