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NPI Code Detail

MEDICARE: DR. REBECCA SHTULMAN PH.D.

MEDICARE: DR. REBECCA SHTULMAN 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
1103G00000XClinical NeuropsychologistPSY.0003481CO

General Provider Information

NPI Number : 1457655433
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA SHTULMAN PH.D.
Provider Business Mailing Address
First Line : 2315 EAST HARMONY ROAD
Second Line : SUITE 100
City : FORT COLLINS
State : CO
Zip : 80528
Country : US
Telephone Number : 970-482-4373
Fax Number : 970-484-5682
Provider Business Practice Location Address
First Line : 2315 E HARMONY RD STE 110
Second Line :
City : FORT COLLINS
State : CO
Zip : 80528-8623
Country : US
Telephone Number : 970-482-4373
Fax Number : 970-484-5682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2011
Last Update Date : 07/21/2022

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