Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0004801 | CO |
Y | 103TC0700X | Clinical Psychologist | 0004801 | CO |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0004801 | CO |
NPI | 1184102790 |
---|---|
Provider Name | Emily Claire Maxwell |
First Address | Englewood, CO 80112-5727 |
Second Address | Englewood, CO 80112-5727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2018 |
Last Update Date | 06/08/2018 |