Provider Demographics
NPI:1518017813
Name:GEE, DICK WONG (EDD)
Entity Type:Individual
Prefix:DR
First Name:DICK
Middle Name:WONG
Last Name:GEE
Suffix:
Gender:M
Credentials:EDD
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:719-548-8388
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:719-548-8388
Practice Address - Fax:719-548-8396
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1179103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO035530OtherVALUE OPTIONS
CO035530Medicaid
CO86766Medicare ID - Type Unspecified