Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1357 | CO |
Y | 103TC0700X | Clinical Psychologist | 1357 | CO |
NPI | 1003059452 |
---|---|
Provider Name | Mrs. Dwight Duncan |
First Address | Denver, CO 80209-4127 |
Second Address | Denver, CO 80209-4127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2009 |
Last Update Date | 26/04/2018 |