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General NPI Number Information
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NPI Number | 1194752436
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Entity Type | Organization
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Legal Business Name | GARY TOUB, PH.D., INC.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 1271 LAFAYETTE ST
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City | DENVER
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State | CO
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Zip | 80218-2315
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Country | US
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Telephone | 303-278-2448
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Fax | 303-394-4933
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Provider Business Mailing Address
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Address Line | 1271 LAFAYETTE ST
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City | DENVER
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State | CO
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Zip | 80218-2315
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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 | PRESIDENT
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Name | DR. GARY S. TOUB
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Credential | PH.D.
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Telephone | 303-278-2448
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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 | 635
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License Number State | CO
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