| NPI | 1750059929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOHANNON Lpc 970-988-4634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101Y00000X Counselor | |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 104100000X Social Worker | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2022-11-04 |