Individual
GILA ETHEL ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2727 PINE STREET, BOULDER, CO 80302
(720) 295-2456
(303) 459-6585
Mailing address
2727 PINE STREET, BOULDER, CO 80302
(720) 295-2456
(303) 459-6588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
41993
CO
2084P0800X
Psychiatry Physician
Primary
41993
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41993
STATE LICENSE
CO
Enumeration date
11/07/2006
Last updated
12/01/2021
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