Healthcare Provider Details

I. General information

NPI: 1194291534
Provider Name (Legal Business Name): MORGAN ANN DOUGLASS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN ANN BOYLE

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1644 S COLLEGE AVE
FORT COLLINS CO
80525-1007
US

IV. Provider business mailing address

1644 S COLLEGE AVE
FORT COLLINS CO
80525-1007
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-0999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY.0007201
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: