Healthcare Provider Details

I. General information

NPI: 1285275040
Provider Name (Legal Business Name): PATRICIA WILSON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 E HAMPDEN AVE
AURORA CO
80014-3902
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax: 303-617-2344
Mailing address:
  • Phone: 303-617-2300
  • Fax: 303-617-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0007047
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: