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NPI Code Detail

MEDICARE: DR. EMILY DEROUIN LP

MEDICARE: DR. EMILY DEROUIN LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist
2103TC1900XCounseling Psychologist4078CO

General Provider Information

NPI Number : 1164777256
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY DEROUIN LP
Provider Business Mailing Address
First Line : 5135 UMATILLA ST
Second Line :
City : DENVER
State : CO
Zip : 80221-1317
Country : US
Telephone Number : 906-553-5266
Fax Number :
Provider Business Practice Location Address
First Line : 50 S STEELE ST STE 950
Second Line :
City : DENVER
State : CO
Zip : 80209-2843
Country : US
Telephone Number : 906-553-5266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 12/11/2023

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