Healthcare Provider Details

I. General information

NPI: 1750373569
Provider Name (Legal Business Name): ANI S. LIGGETT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 BURBANK ST
BROOMFIELD CO
80020-1658
US

IV. Provider business mailing address

1081 ARTEMIS CIR
LAFAYETTE CO
80026-2828
US

V. Phone/Fax

Practice location:
  • Phone: 720-771-7730
  • Fax: 303-664-0243
Mailing address:
  • Phone: 303-664-0243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2386
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: