Individual
DR. PENNIE R. DEXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
159 W. 2ND ST., NEDERLAND, CO 80466
(303) 601-3416
(303) 258-9356
Mailing address
PO BOX 1102, KEYSTONE COUNSELING, LLC, NEDERLAND, CO 80466-1102
(303) 601-3416
(303) 258-9356
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY2854
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11572163
CAQH UNIVERSAL CREDENTIAL
CO
Enumeration date
09/20/2006
Last updated
07/08/2007
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