| NPI | 1356366132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNE BAKER Practice Administrator 719-564-9039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |