Provider Demographics
NPI:1376516419
Name:PAFF BERGEN, LOIS (LOIS PAFF BERGEN PHD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:
Last Name:PAFF BERGEN
Suffix:
Gender:F
Credentials:LOIS PAFF BERGEN PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7857
Mailing Address - Country:US
Mailing Address - Phone:719-532-1701
Mailing Address - Fax:719-548-8396
Practice Address - Street 1:1843 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7857
Practice Address - Country:US
Practice Address - Phone:719-532-1701
Practice Address - Fax:719-548-8396
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist