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General NPI Number Information
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NPI Number | 1003118613
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Entity Type | Organization
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Legal Business Name | DOUG HENNING, PHD, PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 8401 S CHAMBERS RD
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City | PARKER
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State | CO
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Zip | 80134-9498
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Country | US
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Telephone | 720-874-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 S CHAMBERS RD
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City | PARKER
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State | CO
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Zip | 80134-9498
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Country | US
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Telephone | 720-874-2441
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS DAYN HENNING
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Credential | PHD
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Telephone | 720-874-2441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-3398
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License Number State | CO
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