| NPI | 1790436186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE MALLETT Licensed Professional Counselor 719-301-9496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2024-03-25 |