NPI | 1821577719 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSHUA RYAN BURG Co Owner 720-588-0454 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004840) |
Enumeration Date | 2018-08-10 |
Last Update Date | 2021-09-27 |