Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2226 | CO |
NPI | 1114020245 |
---|---|
Provider Name | Ms. Raquel Cagan |
First Address | Boulder, CO 80304-2226 |
Second Address | Boulder, CO 80304-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |