Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2891 | CO |
N | 103TC0700X | Clinical Psychologist | 2891 | CO |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2891 | CO |
NPI | 1083893630 |
---|---|
Provider Name | Dr. Kirk Lang Thoreson |
First Address | Denver, CO 80210-3801 |
Second Address | Denver, CO 80210-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2007 |
Last Update Date | 31/10/2007 |