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General NPI Number Information
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NPI Number | 1083354633
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Entity Type | Organization
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Legal Business Name | NEW PEAKS NEUROPSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 777 29TH ST STE 200
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City | BOULDER
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State | CO
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Zip | 80303-2316
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Country | US
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Telephone | 303-200-4780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 273336
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City | FORT COLLINS
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State | CO
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Zip | 80527-3336
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Country | US
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Telephone | 303-444-3443
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Fax | 970-221-3730
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Authorized Official
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Title or Position | BILLING CONTRACTING MANAGER
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Name | JESSICA KOEPF
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Credential |
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Telephone | 303-444-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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