Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 38367 | CO |
NPI | 1235190794 |
---|---|
Provider Name | Terri Orcutt |
First Address | Fort Collins, CO 80521-2612 |
Second Address | Fort Collins, CO 80521-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BH2942628 | DEA (01) |