Provider Demographics
NPI:1598815730
Name:PROSSER, ANN (PSYD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:PROSSER
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 1:950 S CHERRY ST
Mailing Address - Street 2:STE. 918
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2699
Mailing Address - Country:US
Mailing Address - Phone:303-394-0016
Mailing Address - Fax:303-759-3164
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:STE. 918
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2699
Practice Address - Country:US
Practice Address - Phone:303-394-0016
Practice Address - Fax:303-759-3164
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
CO2294103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical