Provider Demographics
NPI:1417002403
Name:BICKMAN, LOUISE DANNY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:DANNY
Last Name:BICKMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PEARL ST STE 213
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5215
Mailing Address - Country:US
Mailing Address - Phone:303-447-1740
Mailing Address - Fax:
Practice Address - Street 1:1200 PEARL ST STE 213
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5215
Practice Address - Country:US
Practice Address - Phone:303-447-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO546103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist