| NPI | 1477175701 |
|---|---|
| Former Legal Business Name | PRIMARY WITNESS |
| Entity Type | Organization |
| Authorized Contact | THIAGO LEAO Owner 303-875-0145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |