Provider Demographics
NPI:1467847764
Name:BHADURI, ANURADHA (PSYD)
Entity Type:Individual
Prefix:
First Name:ANURADHA
Middle Name:
Last Name:BHADURI
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 1:899 N LOGAN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3155
Mailing Address - Country:US
Mailing Address - Phone:303-756-1197
Mailing Address - Fax:
Practice Address - Street 1:899 N LOGAN ST STE 307
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3155
Practice Address - Country:US
Practice Address - Phone:303-756-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.005380103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist