| NPI | 1689496945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA DOMINGUEZ Clinical Director 970-203-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101200000X Drama Therapist |
| 101YM0800X Counselor, Mental Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 106H00000X Marriage & Family Therapist | |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 221700000X Art Therapist | |
| 225A00000X Music Therapist | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |