| Dawn O Taylor Phd Pc | |
|
3445 Penrose Pl Ste 250 Boulder CO 80301-1877 | |
| (303) 473-4435 | |
| (303) 447-6453 |
| Full Name | Dawn O Taylor Phd Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3445 Penrose Pl Ste 250, Boulder, Colorado |
| Authorized Official Name and Position | Dawn O. Taylor (OWNER) |
| Authorized Official Contact | 3034734435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dawn O Taylor Phd Pc 3445 Penrose Pl Ste 250 Boulder CO 80301-1877 Ph: (303) 473-4435 | Dawn O Taylor Phd Pc 3445 Penrose Pl Ste 250 Boulder CO 80301-1877 Ph: (303) 473-4435 |
| NPI Number | 1093896607 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 08/04/2024 |
| Certification Date | 08/04/2024 |
| Medicare PECOS PAC ID | 6002048725 |
|---|---|
| Medicare Enrollment ID | O20140411001363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093896607 | NPI | - | NPPES |
| 07007313 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Dawn O Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043395924 PECOS PAC ID: 2264464759 Enrollment ID: I20050906000691 |
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