Individual
ELI ALEXANDER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
10350 E DAKOTA AVE, STE B, DENVER, CO 80247-1314
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY.0004356
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027027
KAISER COMMERCIAL NUMBER
CO
05
—
18820077
—
CO
Enumeration date
09/02/2012
Last updated
06/21/2021
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