| NPI | 1669838710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE DAWN SOUCIE Licensed Professional Counselor 970-520-0738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |