Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3152 | CO |
Y | 103TC0700X | Clinical Psychologist | 3152 | CO |
NPI | 1003074618 |
---|---|
Provider Name | Dr. Jane Cleveland |
First Address | Greenwood Village, CO 80111-4747 |
Second Address | Greenwood Village, CO 80111-4747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 14/03/2015 |