Healthcare Provider Details

I. General information

NPI: 1598424723
Provider Name (Legal Business Name): SHANNE PIGOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12503 E EUCLID DR STE 55
CENTENNIAL CO
80111-6466
US

IV. Provider business mailing address

2837 S LANSING WAY
AURORA CO
80014-3086
US

V. Phone/Fax

Practice location:
  • Phone: 954-361-6944
  • Fax:
Mailing address:
  • Phone: 719-989-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: