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NPI 1649470303

NPI 1649470303 : VALERIE J ANDERSON PSYD : COLORADO SPRINGS, CO

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General NPI Number Information
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    NPI Number           |    1649470303
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    Entity Type          |    Individual 
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    Provider Name        |    VALERIE J ANDERSON PSYD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/20/2007
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    Last Update Date     |    05/08/2017
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Provider Practice Location Address
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    Address Line         |    245 E CHEYENNE MOUNTAIN BLVD 
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80906-3719
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    Country              |    US
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    Telephone            |    719-465-1511
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    Fax                  |    270-913-0697
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Provider Business Mailing Address
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    Address Line         |    PO BOX 38061 
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80937-8061
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    Country              |    US
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    Telephone            |    719-465-1511
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    Fax                  |    270-913-0697
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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 3286
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    License Number State |    CO
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