Healthcare Provider Details

I. General information

NPI: 1538371042
Provider Name (Legal Business Name): DR. PRISCILLA DANN-COURTNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 PINE STREET
BOULDER CO
80302
US

IV. Provider business mailing address

1244 PINE STREET
BOULDER CO
80302
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-4470
  • Fax: 303-444-2843
Mailing address:
  • Phone: 303-443-4470
  • Fax: 303-444-2843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number1910
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: