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General NPI Number Information
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NPI Number | 1770911539
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE THERAPEUTIC SOLUTIONS
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 1756 HIGH ST
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City | DENVER
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State | CO
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Zip | 80218-1300
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Country | US
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Telephone | 303-389-6906
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Fax | 303-374-5739
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Provider Business Mailing Address
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Address Line | 1756 HIGH ST
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City | DENVER
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State | CO
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Zip | 80218-1300
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Country | US
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Telephone | 303-389-6906
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Fax | 303-374-5739
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESSICA A DOLGAN
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Credential | PSY.D.
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Telephone | 303-389-6906
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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 | PSY0002996
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License Number State | CO
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