Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2833 | CO |
N | 103G00000X | Clinical Psychologist | 0810002753 | VA |
N | 103TC0700X | Clinical Psychologist | 0810002753 | VA |
Y | 103G00000X | Clinical Psychologist | 2833 | CO |
Y | 103TC0700X | Clinical Psychologist | 2833 | CO |
NPI | 1104871789 |
---|---|
Provider Name | Dr. Susan C Belyea |
First Address | Denver, CO 80236-2028 |
Second Address | Denver, CO 80236-2028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 11/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5681339 | (05) | CO |
680001502 | (05) | VA |