Healthcare Provider Details
I. General information
NPI: 1497597751
Provider Name (Legal Business Name): CURA PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1880 OFFICE CLUB PT STE 141
COLORADO SPRINGS CO
80920-5013
US
IV. Provider business mailing address
1880 OFFICE CLUB PT STE 141
COLORADO SPRINGS CO
80920-5013
US
V. Phone/Fax
- Phone: 719-428-0541
- Fax:
- Phone: 719-428-0541
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MY HAO
PANTUSO
Title or Position: PHD
Credential:
Phone: 719-428-0541