Healthcare Provider Details

I. General information

NPI: 1467466839
Provider Name (Legal Business Name): ANNE COOPER SALAZAR PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 S WADSWORTH BLVD SUITE 370
LAKEWOOD CO
80227-4807
US

IV. Provider business mailing address

3190 S WADSWORTH BLVD SUITE 370
LAKEWOOD CO
80227-4807
US

V. Phone/Fax

Practice location:
  • Phone: 303-980-1258
  • Fax: 303-986-2518
Mailing address:
  • Phone: 303-980-1258
  • Fax: 303-986-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1743
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: