MEDICARE: ABRAHAM SPIES

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
1	103T00000X	Psychologist	PSY.0006592	CO

General Provider Information

NPI Number	:	1215750203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM SPIES

Provider Business Mailing Address
First Line	:	5895 WALSH PT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1259 LAKE PLAZA DR STE 255
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3542
Country	:	US
Telephone Number	:	719-598-3585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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