Healthcare Provider Details

I. General information

NPI: 1821696204
Provider Name (Legal Business Name): JULIA ANNE SADUSKY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 10/16/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 E MISSISSIPPI AVE STE 1300
DENVER CO
80246-3057
US

IV. Provider business mailing address

5052 NE COUNTY LINE RD
ERIE CO
80516-9317
US

V. Phone/Fax

Practice location:
  • Phone: 303-771-0861
  • Fax: 720-889-4258
Mailing address:
  • Phone: 302-535-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0005371
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: