Provider Demographics
NPI:1407473838
Name:BOSCOE-HUFFMAN, JEFF BURTON (PSYD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:BURTON
Last Name:BOSCOE-HUFFMAN
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 1:20330 BROOKMONT
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-8700
Mailing Address - Country:US
Mailing Address - Phone:303-839-1498
Mailing Address - Fax:
Practice Address - Street 1:20330 BROOKMONT
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:CO
Practice Address - Zip Code:80465-8700
Practice Address - Country:US
Practice Address - Phone:303-839-1498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2026103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty