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General NPI Number Information
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NPI Number | 1205432762
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Entity Type | Organization
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Legal Business Name | PEDIATRIC PSYCHOLOGY SERVICES OF COLORADO
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 609 MAIN ST
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City | ALAMOSA
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State | CO
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Zip | 81101-2557
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Country | US
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Telephone | 970-924-0484
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Fax | 970-549-2874
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Provider Business Mailing Address
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Address Line | 1029 COLORADO AVE
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-3319
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Country | US
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Telephone | 970-924-0484
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Fax | 970-549-2874
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Authorized Official
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Title or Position | DIRECTOR OWNER
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Name | JESSICA NICHOLE HARDY SWANN
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Credential | PSY. D
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Telephone | 970-924-0484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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