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General NPI Number Information
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NPI Number | 1629343728
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Entity Type | Organization
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Legal Business Name | PRAXIS PSYCHOTHERAPY AND ASSESSMENTS
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 3107 W COLORADO AVE # 158
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-2088
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Country | US
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Telephone | 719-650-4389
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 HIGH FOREST RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-2026
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Country | US
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Telephone | 719-650-4389
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/OWNER
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Name | DR. KRISTI A ROBERTS
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Credential | PHD
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Telephone | 719-650-4389
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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 | 3651
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License Number State | CO
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