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General NPI Number Information
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NPI Number | 1548653520
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL ASSOCIATES OF THE ROCKIES
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Dates
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Enumeration Date | 03/14/2015
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Last Update Date | 03/14/2015
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Provider Practice Location Address
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Address Line | 6021 S SYRACUSE WAY STE 201
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4747
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Country | US
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Telephone | 303-779-0609
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Fax |
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Provider Business Mailing Address
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Address Line | 6021 S SYRACUSE WAY STE 201
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4747
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Country | US
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Telephone | 303-779-0609
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANE CLEVELAND
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Credential | PSY.D.
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Telephone | 303-779-0609
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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 | 3152
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License Number State | CO
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