| NPI | 1952752131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIE LYNN MATA Licensed Professional Counselor 970-308-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 4971) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |