Organization
PSYCHOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN C. SOPER PH.D. (VP)
(303) 443-1223
Entity
Organization
Contact information
Practice address
613 WALNUT ST, BOULDER, CO 80302-5031
(303) 443-1223
(303) 473-9153
Mailing address
613 WALNUT ST, BOULDER, CO 80302-5031
(303) 443-1223
(303) 473-9153
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
633 AND 1746
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04010732
—
CO
Enumeration date
05/06/2006
Last updated
12/20/2011
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