| 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 |