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Individual

GREGORY W GERRITSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2501 WALNUT ST, SUITE 202, BOULDER, CO 80302-5751
(303) 473-4433
(303) 499-2217
Mailing address
1062 LOVE CT, BOULDER, CO 80303-2975
(303) 473-4433
(303) 499-2217

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1209
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07012099
CO
Enumeration date
10/18/2006
Last updated
10/23/2007
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