Healthcare Provider Details

I. General information

NPI: 1891356796
Provider Name (Legal Business Name): SUZANNE DELAP EDS, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2019
Last Update Date: 06/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S CHERRY ST STE 630
DENVER CO
80246-1233
US

IV. Provider business mailing address

3138 E HINSDALE AVE
CENTENNIAL CO
80122-1945
US

V. Phone/Fax

Practice location:
  • Phone: 303-748-8594
  • Fax:
Mailing address:
  • Phone: 303-748-8594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number282203
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: