| NPI | 1487485843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY REUILLE-DUPONT Medical Owner 970-422-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2024-09-09 |