Individual
DR. ALISA LYNN SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
WARDENBURG STUDENT HEALTH CENTER - PHP, UCB 119, BOULDER, CO 80309-0001
(303) 492-2038
Mailing address
PO BOX 7043, BROOMFIELD, CO 80021-0018
(303) 492-2038
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2787
CO
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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