Crystal Wildes
Clinical Psychologist
4611 Plettner Ln Ste. 100
Evergreen
, Colorado 80439-7396
Crystal Wildes
Clinical Psychologist
4611 Plettner Ln Ste. 100
Evergreen
, Colorado 80439-7396
(720) 443-3112
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Crystal Wildes
- 4611 Plettner Ln Ste. 100
- Evergreen, CO
- Zip : 80439-7396
- Phone : (720) 443-3112
Second Address
- Crystal Wildes
- 4611 Plettner Ln Ste. 100
- Evergreen, CO
- Zip : 80439-7396
- Phone : (720) 443-3112
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FAQs
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What type of doctor is Crystal Wildes
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | PSY.0004027 | CO |
| Y | 103TC0700X | Clinical Psychologist | PSY.0004027 | CO |
National Provider Identifier
| NPI | 1003121898 |
|---|---|
| Provider Name | Crystal Wildes |
| First Address | Evergreen, CO 80439-7396 |
| Second Address | Evergreen, CO 80439-7396 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2010 |
| Last Update Date | 28/12/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.