| NPI | 1386239861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNER DENN Credentialing Specialist 719-428-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 235Z00000X Speech-Language Pathologist | |
| 103T00000X Psychologist | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2024-02-28 |