| NPI | 1396236246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELENIE SNYDER Billing Agent 970-628-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 00000661) |
| Enumeration Date | 2018-05-27 |
| Last Update Date | 2018-10-18 |