| NPI | 1649513284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISA MARIE VAN DYKE President 720-212-8156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2024-04-30 |