| NPI | 1720195142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA FREITAG Billing Manager 970-686-0970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO 2197) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-12-13 |