Individual
DR. GERALD CELEBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
12055 W 2ND PL, LAKEWOOD, CO 80228-1506
(303) 425-4480
Mailing address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.0003073
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA105814
MEDICARE INDIVIDUAL PTAN
CO
Enumeration date
11/05/2007
Last updated
06/10/2021
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