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NPI Code Detail

MEDICARE: DR. BARBARA F JEDRZEJEK PSYD, LP

MEDICARE: DR. BARBARA F JEDRZEJEK PSYD, LP
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
1103TC0700XClinical PsychologistPSY.0005032CO

General Provider Information

NPI Number : 1952778367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARBARA F JEDRZEJEK PSYD, LP
Provider Business Mailing Address
First Line : 1942 BROADWAY STE 314C
Second Line :
City : BOULDER
State : CO
Zip : 80302-5233
Country : US
Telephone Number : 720-263-9123
Fax Number :
Provider Business Practice Location Address
First Line : 1942 BROADWAY STE 314C
Second Line :
City : BOULDER
State : CO
Zip : 80302-5233
Country : US
Telephone Number : 720-263-9123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 12/29/2021

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