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General NPI Number Information
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NPI Number | 1013300243
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Entity Type | Individual
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Provider Name | DR. JESSICA GELLER
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Gender | Female
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 950 N LOGAN ST STE 101
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City | DENVER
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State | CO
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Zip | 80203-3009
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Country | US
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Telephone | 303-476-8165
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 GLENARM PL APT 1002
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City | DENVER
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State | CO
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Zip | 80202-4315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PSY.0004716
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License Number State | CO
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