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General NPI Number Information
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NPI Number | 1376070805
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Entity Type | Organization
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Legal Business Name | PEAK MIND CONSULTING
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 156 SPRING MEADOW DR
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City | SPRINGTOWN
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State | TX
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Zip | 76082-1140
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Country | US
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Telephone | 719-357-6462
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Fax | 719-203-4485
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Provider Business Mailing Address
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Address Line | 156 SPRING MEADOW DR
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City | SPRINGTOWN
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State | TX
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Zip | 76082-1140
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Country | US
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Telephone | 636-699-3015
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Fax | 719-203-4485
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | DR. EMILY B RADEMAN
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Credential | PSYD
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Telephone | 719-357-6462
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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 | 4289
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License Number State | CO
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