Individual
DR. GARY LEE KAAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8790 W COLFAX AVE, SUITE 250, LAKEWOOD, CO 80215-4092
(303) 234-0827
(303) 234-1771
Mailing address
8790 W COLFAX AVE, SUITE 250, LAKEWOOD, CO 80215-4092
(303) 234-0827
(303) 234-1771
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1212
CO
103TC0700X
Clinical Psychologist
Primary
1212
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07012123
—
CO
01
—
229797
COMPSYCH
CO
01
—
470920477
TRICARE PROVIDER
CO
01
—
90226
CIGNA BEHAVIORAL HEALTH
CO
Enumeration date
10/02/2006
Last updated
08/18/2008
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