| NPI | 1861063471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Credentialing Manager 970-624-4443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2021-07-06 |