Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY.0000975 | CO |
Y | 103T00000X | Psychologist | PSY.0000975 | CO |
NPI | 1003208307 |
---|---|
Provider Name | Frances M Henderson |
First Address | Wheat Ridge, CO 80033-2184 |
Second Address | Denver, CO 80224-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2015 |
Last Update Date | 23/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY.0000975 | PROFESSIONAL LICENSE (01) | CO |