Healthcare Provider Details

I. General information

NPI: 1134069719
Provider Name (Legal Business Name): CAITLIN FRANCES MCKIMMY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5495 ARAPAHOE AVE
BOULDER CO
80303-1200
US

IV. Provider business mailing address

5495 ARAPAHOE AVE
BOULDER CO
80303-1200
US

V. Phone/Fax

Practice location:
  • Phone: 130-354-4390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: