| NPI | 1376070805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY B RADEMAN Operations Manager 719-357-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4289) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-06-04 |