| NPI | 1902318827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN RUTH ANDERSON Owner 070-286-4886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CW-00001959) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2022-10-13 |