Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 1211 | CO |
Y | 103TC0700X | Clinical Psychologist | 1211 | CO |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TF0200X | Forensic Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1124302070 |
---|---|
Provider Name | Dr. Beverly Sue Jennings |
First Address | Denver, CO 80210-3934 |
Second Address | Denver, CO 80210-3934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2011 |
Last Update Date | 10/10/2011 |