| NPI | 1417752361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE WILSON Owner 719-640-0668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-03-05 |