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NPI Code Detail

MEDICARE: NANCY T. DASSOFF PH.D.

MEDICARE: NANCY T. DASSOFF PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician071004945IL
2103TC0700XClinical Psychologist071004945IL

General Provider Information

NPI Number : 1093727430
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY T. DASSOFF PH.D.
Provider Business Mailing Address
First Line : 4860 ROBB ST STE 201
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-2162
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Provider Business Practice Location Address
First Line : 3625 PARKMOOR VILLAGE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5205
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 09/15/2020

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