Individual
SALLY TARBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 876, AURORA, CO 80040-0876
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3486
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33101566
—
CO
Enumeration date
04/16/2007
Last updated
01/04/2011
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