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General NPI Number Information
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NPI Number | 1871618728
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Entity Type | Individual
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Provider Name | MIGUELINA J VARGAS PHD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 1304 N ACADEMY BLVD SUITE 204
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-3325
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Country | US
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Telephone | 719-205-4309
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Fax | 719-465-3576
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Provider Business Mailing Address
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Address Line | 4175 SANDBERG DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-3441
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Country | US
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Telephone | 719-205-4309
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Fax | 719-205-4309
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2647
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License Number State | CO
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