| NPI | 1700029030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DOVE Counseling Supervisor 719-389-6384 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 1569) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 2589) |
| 101YP2500X Counselor, Professional (Licence: CO 422) | |
| 103TC0700X Psychologist, Clinical (Licence: CO 2810) | |
| 1041C0700X Social Worker, Clinical (Licence: CO 989086) | |
| 1041C0700X Social Worker, Clinical (Licence: CO 989775) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 27976) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |