=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699089284
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATRICIA E. PIRRELLO, PH.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2010
-----------------------------------------------------
Last Update Date | 08/05/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6290 LEHMAN DR SUITE 202
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80918-1471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-599-7882
-----------------------------------------------------
Fax | 719-598-1437
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6290 LEHMAN DR SUITE 202
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80918-1471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-599-7882
-----------------------------------------------------
Fax | 719-598-1437
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL PSYCHOLOGIST
-----------------------------------------------------
Name | DR. PATRICIA ELIZABETH PIRRELLO
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 719-599-7882
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 1443
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------