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Individual

DR. ERNEST T. SOPER III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

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
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07102601
CO
Enumeration date
05/04/2006
Last updated
12/22/2011
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