Individual
DR. JILLIAN BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-3800
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-3800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1476
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021040
KAISER COMMERCIAL NUMBER
CO
05
—
97935727
—
CO
Enumeration date
04/12/2010
Last updated
09/07/2010
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