| NPI | 1467963447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK STEVEN MCCOY President 970-493-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |