Provider Demographics
NPI:1265640627
Name:NIELSON, DEBRA K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:K
Last Name:NIELSON
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 1:800 PEARL ST APT 402
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3330
Mailing Address - Country:US
Mailing Address - Phone:720-301-2185
Mailing Address - Fax:
Practice Address - Street 1:671 GRANT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3506
Practice Address - Country:US
Practice Address - Phone:720-301-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical