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General NPI Number Information
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NPI Number | 1740934280
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Entity Type | Organization
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Legal Business Name | A CLEAR VIEW-RACETTE PSYCHOLOGICAL
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1802 CHAPEL HILLS DR STE G
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3736
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Country | US
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Telephone | 719-203-2894
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Fax | 719-982-7845
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Provider Business Mailing Address
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Address Line | 1802 CHAPEL HILLS DR STE G
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3736
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Country | US
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Telephone | 719-203-2894
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Fax | 719-982-7845
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Authorized Official
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Title or Position | OWNER
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Name | MELISA ROSE RACETTE
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Credential |
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Telephone | 719-203-2894
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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 |
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License Number State |
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