| NPI | 1770169963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE EDGAR Medical Reimbursement Manager 720-501-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-03-19 |