=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356558977
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIFFANY WEISSMANN WIND PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3300 E 1ST AVE SUITE 650
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80206-5810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-829-9724
-----------------------------------------------------
Fax | 303-393-0167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3300 E 1ST AVE SUITE 650
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80206-5810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-829-9724
-----------------------------------------------------
Fax | 303-393-0167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 1952
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------