Provider Demographics
NPI:1346238367
Name:WECHSLER, RALPH COLTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:COLTON
Last Name:WECHSLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2902
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-1425
Mailing Address - Country:US
Mailing Address - Phone:303-397-0318
Mailing Address - Fax:303-805-1540
Practice Address - Street 1:11031 S PIKES PEAK DR
Practice Address - Street 2:SUITE G-103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7389
Practice Address - Country:US
Practice Address - Phone:303-397-0318
Practice Address - Fax:303-805-1540
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1130103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical