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NPI Code Detail

MEDICARE: BECKIE M. GRGICH

MEDICARE: BECKIE M. GRGICH
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
1251S00000XCommunity/Behavioral Health Agency3041CO

General Provider Information

NPI Number : 1285918870
Entity Type Code : Organization
Provider Name (Legal Business Name) : BECKIE M. GRGICH
Provider Business Mailing Address
First Line : 1155 KELLY JOHNSON BLVD STE 111
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3957
Country : US
Telephone Number : 719-315-0951
Fax Number : 719-313-9210
Provider Business Practice Location Address
First Line : 1155 KELLY JOHNSON BLVD STE 111
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3957
Country : US
Telephone Number : 719-315-0951
Fax Number : 719-313-9210
Authorized Official
Title or Position : SOLE PROPRIETOR
Name : DR. BECKIE M. GRGCIH
Credential : PSY.D.
Telephone Number : 719-315-0951
Provider Enumeration Date : 09/30/2011
Last Update Date : 09/30/2011

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Directions to “BECKIE M. GRGICH ” Practice Location

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