Organization
A WISERMIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL E KOSTELNIK (VICE PRESIDENT)
(303) 946-5003
Entity
Organization
Contact information
Practice address
20343 N HAYDEN RD # 105-446, SCOTTSDALE, AZ 85255-3876
(602) 930-8462
Mailing address
6000 E EVANS, BLDG 3 STE 100, DENVER, CO 80222
(303) 951-4323
(877) 926-0262
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
03/02/2011
Last updated
10/17/2018
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