| NPI | 1528448156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA LEE HEDMAN Owner 719-200-7361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0013943) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-06-09 |