NPI | 1538149497 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM GLENN BORDELON Owner/Officer 970-245-3212 |
Organization Subpart ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 649) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 1428) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2025-09-11 |