Provider Demographics
NPI:1073680369
Name:O'BRIEN, BETH (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 W DRAKE RD STE 124
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-8115
Mailing Address - Country:US
Mailing Address - Phone:970-491-9689
Mailing Address - Fax:
Practice Address - Street 1:323 W DRAKE RD STE 124
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-8115
Practice Address - Country:US
Practice Address - Phone:970-491-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1997103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling