| NPI | 1659807550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE KELLY Sole Proprietor 720-338-0324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 708) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |