| NPI | 1912606898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON HANSEN Owner 970-400-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-08-14 |