| NPI | 1891112587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA RENETTA DUNSON Licensed Professional Counselor 719-237-0409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 6512) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |