| NPI | 1730711474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BAGWELL Licensed Clinical Psychologist 720-507-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-04-02 |