NPI | 1912645458 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY FRAILEY Hr 719-389-1108 |
Organization Subpart ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2022-05-24 |
Last Update Date | 2022-05-24 |