Individual
BRIAN L BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1501 ALBION ST, DENVER, CO 80220-1028
(303) 399-4890
Mailing address
1501 ALBION ST, DENVER, CO 80220-1028
(303) 399-4890
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2809
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46838848
—
CO
Enumeration date
04/19/2007
Last updated
07/08/2007
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