| NPI | 1740814433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-875-2633 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2024-10-16 |