Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2878 | CO |
Y | 103G00000X | Clinical Psychologist | 2878 | CO |
Y | 103TC0700X | Clinical Psychologist | 2878 | CO |
N | 103TH0100X | Health Service | 2878 | CO |
NPI | 1194041251 |
---|---|
Provider Name | Dr. John Whitney Steele |
First Address | Boulder, CO 80305-6404 |
Second Address | Boulder, CO 80305-6404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 14/04/2010 |