| NPI | 1902537475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLAREE BLAKE Owner/Licensed Clinical Psychologis 720-386-4046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-24 |