| NPI | 1760162135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER ORR Onwer 719-354-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-10-04 |