Individual
AUDREY BLAKELEY-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13121 E 17TH AVE, AURORA, CO 80045-2535
(303) 315-6507
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY.0003008
CO
103T00000X
Psychologist
3008
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26087073
—
CO
Enumeration date
08/31/2006
Last updated
09/10/2021
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