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NPI Code Detail

MEDICARE: DR. JANICE DALE ORT PSY.D.

MEDICARE:  DR. JANICE DALE ORT  PSY.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
1103TC0700XClinical Psychologist1606CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992875462
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANICE DALE ORT PSY.D.
Provider Business Mailing Address
First Line : 375 E HORSETOOTH RD
Second Line : BUILDING 2-203
City : FORT COLLINS
State : CO
Zip : 80525-3155
Country : US
Telephone Number : 970-377-9443
Fax Number : 970-204-6985
Provider Business Practice Location Address
First Line : 375 E HORSETOOTH RD
Second Line : BUILDING 2-203
City : FORT COLLINS
State : CO
Zip : 80525-3155
Country : US
Telephone Number : 970-377-9443
Fax Number : 970-204-6985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 07/08/2007

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