Healthcare Provider Details

I. General information

NPI: 1780935882
Provider Name (Legal Business Name): EMILY ANN INMAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 N HANCOCK AVE SUITE 5N
COLORADO SPRINGS CO
80903-2618
US

IV. Provider business mailing address

1283 KELLY JOHNSON BLVD STE 200
COLORADO SPRINGS CO
80920-3925
US

V. Phone/Fax

Practice location:
  • Phone: 719-650-8559
  • Fax: 719-447-0371
Mailing address:
  • Phone: 719-413-6776
  • Fax: 719-203-6847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3997
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3997
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: