Provider Demographics
NPI:1104207356
Name:GAUTHIER, ALICIA (PSYD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 S HARLAN ST # 2-117
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2711
Mailing Address - Country:US
Mailing Address - Phone:720-663-1271
Mailing Address - Fax:
Practice Address - Street 1:8 W DRY CREEK CIR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4477
Practice Address - Country:US
Practice Address - Phone:720-515-6802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist