Individual
JESSICA EGUSQUIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4597
(303) 602-2318
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4597
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
PSY.0005650
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/10/2015
Last updated
11/04/2021
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