Individual
DR. JAMES K CHILDERSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2641 TAFT AVE STE 203, LOVELAND, CO 80538-3121
(301) 991-1018
Mailing address
1910 SUNSHINE PEAK DR, LOVELAND, CO 80538-7217
(301) 991-1018
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
02307
MD
103TC0700X
Clinical Psychologist
Primary
2307
MD
103TC1900X
Counseling Psychologist
02307
MD
103TC2200X
Clinical Child & Adolescent Psychologist
02307
MD
Other
Enumeration date
07/01/2005
Last updated
09/05/2024
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