Individual
EDWARD PHILLIP MOCKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5277 MANHATTAN CIR STE 102, BOULDER, CO 80303-8200
(720) 526-0579
Mailing address
5277 MANHATTAN CIR STE 102, BOULDER, CO 80303-8200
(720) 526-0579
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0004518
CO
Other
Enumeration date
07/15/2014
Last updated
03/04/2021
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