| NPI | 1619772571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID ANDREW YEAW Owner 719-725-7761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-04-23 |