Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY.0005537 | CO |
NPI | 1083082671 |
---|---|
Provider Name | Deepika Patel |
First Address | Aurora, CO 80042-0429 |
Second Address | Colorado Springs, CO 80920-7804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2015 |
Last Update Date | 06/01/2022 |