| NPI | 1417800293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA ROACH Credentialing Manager 970-329-7161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 106H00000X Marriage & Family Therapist | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2026-02-19 |
| Last Update Date | 2026-02-19 |