MEDICARE: PATRICIA E. PIRRELLO, PH.D., P.C.

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	1443	CO

General Provider Information

NPI Number	:	1699089284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA E. PIRRELLO, PH.D., P.C.

Provider Business Mailing Address
First Line	:	6290 LEHMAN DR
Second Line	:	SUITE 202
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1471
Country	:	US
Telephone Number	:	719-599-7882
Fax Number	:	719-598-1437

Provider Business Practice Location Address
First Line	:	6290 LEHMAN DR
Second Line	:	SUITE 202
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1471
Country	:	US
Telephone Number	:	719-599-7882
Fax Number	:	719-598-1437

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. PATRICIA ELIZABETH PIRRELLO
Credential	:	PH.D.
Telephone Number	:	719-599-7882

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/05/2010

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