Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1639415490 |
---|---|
Provider Name | Christopher Cummins |
First Address | Westminster, CO 80234 |
Second Address | Westminster, CO 80234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2012 |
Last Update Date | 30/01/2018 |