NPI | 1861026809 |
---|---|
Entity Type | Organization |
Authorized Contact | KATE BOGUE Credentiaing 719-632-4455 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 101Y00000X Counselor |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
Enumeration Date | 2020-02-28 |
Last Update Date | 2020-10-26 |