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General NPI Number Information
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NPI Number | 1215549886
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Entity Type | Organization
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Legal Business Name | BRAIN AND BODY INSIGHTS
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 14960 WOODCARVER RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-2370
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Country | US
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Telephone | 719-344-8779
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Fax | 719-313-9210
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Provider Business Mailing Address
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Address Line | 14241 S REDWOOD RD STE 153
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City | BLUFFDALE
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State | UT
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Zip | 84065-5223
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Country | US
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Telephone | 801-819-8719
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Fax | 719-313-9210
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Authorized Official
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Title or Position | OWNER
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Name | DR. BECKIE M GRGICH
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Credential | PSY.D.
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Telephone | 719-344-8779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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