| NPI | 1659534816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE PATTILLO Clinical Director 719-264-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 690) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO 691) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |