Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY.0003021 | CO |
N | 103TC0700X | Clinical Psychologist | PSY.0003021 | CO |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 3021 | CO |
NPI | 1124358445 |
---|---|
Provider Name | Dr. Elizabeth Bennett |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2010 |
Last Update Date | 10/09/2021 |