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Individual

IAN DAVID PASIKOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
954 NORTH ST, SUITE 301, BOULDER, CO 80304-3307
(303) 442-6366
Mailing address
954 NORTH ST, SUITE 301, BOULDER, CO 80304-3307
(303) 442-6366

Taxonomy

Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary

Other

Enumeration date
09/25/2007
Last updated
09/25/2007
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