Organization
LIFE ENHANCEMENT TECHNOLOGIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRIAM BLUM PH.D. (PRESIDENT)
(719) 531-6078
Entity
Organization
Contact information
Practice address
1414 N NEVADA AVE, COLORADO SPRINGS, CO 80907-7431
(719) 531-6078
Mailing address
PO BOX 62595, COLORADO SPRINGS, CO 80962-2595
(719) 531-6078
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1167
CO
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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