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General NPI Number Information
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NPI Number | 1013288661
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Entity Type | Organization
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Legal Business Name | WARRIOR RELAXATION RESPONSE CENTER
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 2535 AIRPORT RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3119
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Country | US
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Telephone | 719-339-6313
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Fax |
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Provider Business Mailing Address
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Address Line | 2535 AIRPORT RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3119
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Country | US
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Telephone | 719-339-6313
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR OF CLINICAL SERVICES
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Name | MS. SALLIE ANNETTE HARPER
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Credential | LPC
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Telephone | 719-963-0428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1184
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 255
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5274
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License Number State | CO
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