Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1153 | CO |
N | 103T00000X | Psychologist | 1153 | CO |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1153 | CO |
N | 103G00000X | Clinical Psychologist | 1153 | CO |
N | 103TC0700X | Clinical Psychologist | 1153 | CO |
N | 103TF0200X | Forensic Psychologist | 1153 | CO |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1153 | CO |
N | 103TS0200X | School Psychologist | 344980 | CO |
NPI | 1033277421 |
---|---|
Provider Name | Dr. Paul Alexander Spragg |
First Address | Denver, CO 80203-2136 |
Second Address | Denver, CO 80203-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04142121 | (05) | CO |
07026198 | (05) | CO |
R19090 | (02) | CO |
UR 19323 | DIV VOC REHAB (01) | CO |