Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY.0004676 | CO |
Y | 103TC0700X | Clinical Psychologist | PSY.0004676 | CO |
NPI | 1003389651 |
---|---|
Provider Name | Dr. Matthew W Mccall |
First Address | Denver, CO 80210-3955 |
Second Address | Denver, CO 80210-3955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2019 |
Last Update Date | 23/07/2021 |