J. Blair Cano, Psyd, Mscp | |
77 3rd St # 400 Monument CO 80132-8179 | |
(719) 964-8953 | |
Not Available |
Full Name | J. Blair Cano, Psyd, Mscp |
---|---|
Speciality | Psychologist |
Location | 77 3rd St # 400, Monument, Colorado |
Authorized Official Name and Position | Jessica Hetrick-cano (OWNER) |
Authorized Official Contact | 7199648953 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
J. Blair Cano, Psyd, Mscp 1938 Wood Ave Colorado Springs CO 80907-6715 Ph: (719) 964-8953 | J. Blair Cano, Psyd, Mscp 77 3rd St # 400 Monument CO 80132-8179 Ph: (719) 964-8953 |
NPI Number | 1689282444 |
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Provider Enumeration Date | 07/17/2020 |
Last Update Date | 07/27/2020 |
Certification Date | 07/27/2020 |
Medicare PECOS PAC ID | 1557788312 |
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Medicare Enrollment ID | O20200826000210 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689282444 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Jessica B Hetrick-cano |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1730444142 PECOS PAC ID: 2466879226 Enrollment ID: I20200826000287 |
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