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General NPI Number Information
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NPI Number | 1407128879
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Entity Type | Individual
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Provider Name | ROBERT ROSENTHAL PSYD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 4155 E JEWELL AVE STE 907
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City | DENVER
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State | CO
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Zip | 80222-4513
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Country | US
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Telephone | 720-319-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 4155 E JEWELL AVE STE 907
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City | DENVER
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State | CO
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Zip | 80222-4513
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Country | US
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Telephone | 720-319-7272
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3655
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License Number State | CO
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