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General NPI Number Information
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NPI Number | 1578842043
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Entity Type | Organization
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Legal Business Name | CROSSWIND PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/15/2011
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 10029 W 82ND LN
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City | ARVADA
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State | CO
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Zip | 80005-5236
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Country | US
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Telephone | 303-736-9965
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Fax |
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Provider Business Mailing Address
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Address Line | 10029 W 82ND LN
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City | ARVADA
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State | CO
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Zip | 80005-5236
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | AMY MILKAVICH
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Credential | PSY.D
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Telephone | 303-736-9965
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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 | 3540
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License Number State | CO
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