MEDICARE: DR. ERIN E SHRAGO PSY.D.

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	103TC0700X	Clinical Psychologist	2975	CO

General Provider Information

NPI Number	:	1649892704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN E SHRAGO PSY.D.

Provider Business Mailing Address
First Line	:	600 S CHERRY ST STE 1111
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-1716
Country	:	US
Telephone Number	:	303-756-1374
Fax Number	:	303-756-1246

Provider Business Practice Location Address
First Line	:	600 S CHERRY ST STE 1111
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-1716
Country	:	US
Telephone Number	:	303-756-1374
Fax Number	:	303-756-1246

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

Provider Enumeration Date	:	05/12/2020
Last Update Date	:	05/12/2020

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