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Individual

JESSICA BOER CASTELO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
499 E HAMPDEN AVE, SUITE 360, ENGLEWOOD, CO 80113-2780
(303) 781-4485
(303) 306-7753
Mailing address
PO BOX 17528, DENVER, CO 80217-0528
(405) 682-3303
(405) 384-6793

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3756
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY.0003756
COLORADO MEDICAL LICENSE
CO
Enumeration date
08/06/2007
Last updated
07/07/2020
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