Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2658 | CO |
Y | 103TC0700X | Clinical Psychologist | 2658 | CO |
N | 103G00000X | Clinical Psychologist | PS005532L | PA |
N | 103TC0700X | Clinical Psychologist | PS005532L | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2658 | CO |
N | 103TH0100X | Health Service | 2658 | CO |
NPI | 1134136831 |
---|---|
Provider Name | Dr. Carol Olivia Loadman-Copeland |
First Address | Centennial, CO 80112-1260 |
Second Address | Centennial, CO 80112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 07/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02733587 | (05) | CO |
42002 | NATIONAL CERTIFIED CNSLR (01) | |
PO08840 | TRICARE NO. (01) | PA |
R135 | ASCH CERT - CLIN HYPNOSIS (01) | |
R98092 | (02) |