| NPI | 1407539885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA C DALEN Practice Owner 719-445-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2024-06-07 |