| NPI | 1972094183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY KISER President/Owner 970-812-3162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 13433) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |