Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 0004219 | CO |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0004219 | CO |
Y | 103G00000X | Clinical Psychologist | 0004219 | CO |
Y | 103TC0700X | Clinical Psychologist | 0004219 | CO |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 0004219 | CO |
NPI | 1871980821 |
---|---|
Provider Name | Dr. Lisa Townsend |
First Address | Colorado Springs, CO 80903-1410 |
Second Address | Colorado Spgs, CO 80903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 29/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004219 | COLORADO LICENSED PSYCHOLOGIST (01) | CO |