Healthcare Provider Details

I. General information

NPI: 1992903017
Provider Name (Legal Business Name): ELIZABETH ANNE NELSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 SOUTH BELLAIRE STREET SUITE 204
DENVER CO
80222
US

IV. Provider business mailing address

1720 SOUTH BELLAIRE STREET
DENVER CO
80222
US

V. Phone/Fax

Practice location:
  • Phone: 303-547-3591
  • Fax:
Mailing address:
  • Phone: 303-547-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number013351
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number013351
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY0003469
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: