Healthcare Provider Details

I. General information

NPI: 1629431317
Provider Name (Legal Business Name): DRAGONFLY PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 E DRY CREEK RD STE G102
CENTENNIAL CO
80112-2574
US

IV. Provider business mailing address

7408 E LONG CIR
CENTENNIAL CO
80112-2657
US

V. Phone/Fax

Practice location:
  • Phone: 303-771-0449
  • Fax: 720-708-3074
Mailing address:
  • Phone: 303-771-0449
  • Fax: 720-708-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2658
License Number StateCO

VIII. Authorized Official

Name: CAROL O LOADMAN-COPELAND
Title or Position: PSYCHOLOGIST/OWNER
Credential: PH.D.
Phone: 303-771-0449