Broadvistas Psychology Llc | |
12230 Lioness Way Parker CO 80134-5603 | |
(888) 948-6789 | |
(877) 345-3501 |
Full Name | Broadvistas Psychology Llc |
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Speciality | Psychologist - Clinical |
Location | 12230 Lioness Way, Parker, Colorado |
Authorized Official Name and Position | Thomas Judson Broadhurst (OWNER) |
Authorized Official Contact | 3032787418 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Broadvistas Psychology Llc 1 Kalisa Way Ste 101 Paramus NJ 07652-3508 Ph: (888) 948-6789 | Broadvistas Psychology Llc 12230 Lioness Way Parker CO 80134-5603 Ph: (888) 948-6789 |
NPI Number | 1679197065 |
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Provider Enumeration Date | 06/02/2020 |
Last Update Date | 01/06/2023 |
Certification Date | 01/06/2023 |
Identifier | Type | State | Issuer |
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1679197065 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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