Provider Demographics
NPI:1366674343
Name:LAMPELA, JILL YVETTE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:YVETTE
Last Name:LAMPELA
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 1:545 W SLICE DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-6007
Mailing Address - Country:US
Mailing Address - Phone:719-251-6295
Mailing Address - Fax:
Practice Address - Street 1:545 W SLICE DR
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-6007
Practice Address - Country:US
Practice Address - Phone:719-251-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3385103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist