Healthcare Provider Details

I. General information

NPI: 1265752554
Provider Name (Legal Business Name): LIA BILLINGTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 GALLINA PEAK
SANTA FE NM
87508-1439
US

IV. Provider business mailing address

12128 W COOPER DR
LITTLETON CO
80127-4861
US

V. Phone/Fax

Practice location:
  • Phone: 720-470-7980
  • Fax: 575-571-4344
Mailing address:
  • Phone: 720-470-7980
  • Fax: 575-571-4344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1128
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: