Provider Demographics
NPI:1528213691
Name:HALDERMAN, COLBY DEAN (BA)
Entity Type:Individual
Prefix:MR
First Name:COLBY
Middle Name:DEAN
Last Name:HALDERMAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 W 11TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3780
Mailing Address - Country:US
Mailing Address - Phone:541-868-0661
Mailing Address - Fax:541-868-0660
Practice Address - Street 1:1790 W 11TH AVE STE A
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3780
Practice Address - Country:US
Practice Address - Phone:541-868-0661
Practice Address - Fax:541-868-0660
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health