Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1053929406 |
---|---|
Provider Name | Daniel K. Sage |
First Address | Centennial, CO 80015-2542 |
Second Address | Aurora, CO 80015-1079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2020 |
Last Update Date | 21/07/2020 |