Healthcare Provider Details

I. General information

NPI: 1033757109
Provider Name (Legal Business Name): SAUDER PSYCHOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9085 E. MINERAL CIR, SUITE 235
CENTENNIAL CO
80112
US

IV. Provider business mailing address

9085 E. MINERAL CIR, SUITE 235
CENTENNIAL CO
80112
US

V. Phone/Fax

Practice location:
  • Phone: 720-548-7825
  • Fax:
Mailing address:
  • Phone: 720-548-7825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. HEIDI ANDERSON SAUDER
Title or Position: OWNER
Credential: PHD
Phone: 720-548-7825