| NPI | 1538029988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA C RUSSELL Chief Executive Officer 970-471-3981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-11-17 |
| Last Update Date | 2025-11-17 |