Organization
SOURCE PSYCHIATRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY HINSHAW (PRACTICE MANAGER)
(720) 310-0656
Entity
Organization
Contact information
Practice address
1942 BROADWAY STE 314C, BOULDER, CO 80302-5233
(720) 310-0656
Mailing address
1942 BROADWAY STE 314C, BOULDER, CO 80302-5233
(720) 310-0656
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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