Healthcare Provider Details

I. General information

NPI: 1760936983
Provider Name (Legal Business Name): ELIZABETH WEHNER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S CHERRY ST SUITE 712
DENVER CO
80246-2699
US

IV. Provider business mailing address

950 S CHERRY ST SUITE 712
DENVER CO
80246-2699
US

V. Phone/Fax

Practice location:
  • Phone: 303-316-5045
  • Fax: 303-305-7142
Mailing address:
  • Phone: 303-316-5045
  • Fax: 303-305-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1942
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: