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General NPI Number Information
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NPI Number | 1417984253
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Entity Type | Individual
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Provider Name | CHAD DUANE EMRICK PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 950 S CHERRY ST STE 424
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City | DENVER
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State | CO
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Zip | 80246-2612
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Country | US
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Telephone | 303-507-5035
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Fax | 303-393-4603
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Provider Business Mailing Address
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Address Line | PO BOX 472635
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City | AURORA
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State | CO
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Zip | 80047-2635
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Country | US
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Telephone | 303-290-0575
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Fax | 303-393-5272
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 414
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License Number State | CO
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