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General NPI Number Information
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NPI Number | 1407379092
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Entity Type | Individual
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Provider Name | TODD C. OGNIBENE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 11/22/2017
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Provider Practice Location Address
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Address Line | 1544 YORK STREET, THIRD FLOOR
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City | DENVER
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State | CO
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Zip | 80206
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Country | US
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Telephone | 303-550-7832
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270587
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City | LITTLETON
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State | CO
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Zip | 80127-0010
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Country | US
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Telephone | 303-917-0689
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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 | PSY.0004610
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License Number State | CO
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