Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2046 | CO |
Y | 103T00000X | Psychologist | 2046 | CO |
NPI | 1003927955 |
---|---|
Provider Name | Dr. Judy Pomerantz |
First Address | Glendale, CO 80246-3048 |
Second Address | Glendale, CO 80246-3048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
87020464 | (05) | CO |