| NPI | 1902236417 |
|---|---|
| Other Name | FULL NAME SUSAN BEAUSOLEIL BOGRAD |
| Entity Type | Organization |
| Authorized Contact | SUSAN BOGRAD Owner 303-320-1968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 34363) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: CO 34363) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |