Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 4843 | CO |
Y | 103G00000X | Clinical Psychologist | 4843 | CO |
Y | 103TC0700X | Clinical Psychologist | 4843 | CO |
N | 103TC1900X | Counseling Psychologist | 4843 | CO |
NPI | 1114495900 |
---|---|
Provider Name | Dr. Robyn Lea Hacker |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2018 |
Last Update Date | 03/04/2019 |