Healthcare Provider Details

I. General information

NPI: 1639295264
Provider Name (Legal Business Name): PAMELA A DANIEL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9139 RIDGELINE BLVD
HIGHLANDS RANCH CO
80129-2333
US

IV. Provider business mailing address

9139 RIDGELINE BLVD
HIGHLANDS RANCH CO
80129-2333
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-3800
  • Fax:
Mailing address:
  • Phone: 303-338-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2576
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2576
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: