Provider Demographics
NPI:1215002472
Name:PIPER, DALE ALAN (PSYD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:ALAN
Last Name:PIPER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N WEBER ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2921
Mailing Address - Country:US
Mailing Address - Phone:719-448-9464
Mailing Address - Fax:719-448-9467
Practice Address - Street 1:916 N WEBER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2921
Practice Address - Country:US
Practice Address - Phone:719-448-9464
Practice Address - Fax:719-448-9467
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2558103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist