| NPI | 1629936620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL MICHELLE BRADLEY Licensed Clinical Social Worker 719-459-9034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2026-01-10 |
| Last Update Date | 2026-01-10 |