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General NPI Number Information
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NPI Number | 1073680369
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Entity Type | Individual
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Provider Name | BETH O'BRIEN PH.D. PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 323 W DRAKE RD STE 124
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City | FORT COLLINS
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State | CO
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Zip | 80526-8115
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Country | US
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Telephone | 970-491-9689
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Fax |
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Provider Business Mailing Address
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Address Line | 323 W DRAKE RD STE 124
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City | FORT COLLINS
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State | CO
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Zip | 80526-8115
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Country | US
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Telephone | 970-491-9689
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1997
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License Number State | CO
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