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General NPI Number Information
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NPI Number | 1306186119
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Entity Type | Individual
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Provider Name | JESSICA YOUNG PAE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 7921 SOUTHPARK PLZ SUITE 204
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City | LITTLETON
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State | CO
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Zip | 80120-5630
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Country | US
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Telephone | 720-489-8555
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Fax | 720-489-8304
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Provider Business Mailing Address
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Address Line | 7921 SOUTHPARK PLZ SUITE 204
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City | LITTLETON
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State | CO
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Zip | 80120-5630
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Country | US
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Telephone | 720-489-8555
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Fax | 720-489-8304
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0003870
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License Number State | CO
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