Provider Demographics
NPI:1629042593
Name:THYE, RUSSELL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:A
Last Name:THYE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:2530 ABARR DR
Mailing Address - Street 2:STE 120B
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3170
Mailing Address - Country:US
Mailing Address - Phone:970-622-9715
Mailing Address - Fax:970-622-9736
Practice Address - Street 1:2530 ABARR DR
Practice Address - Street 2:STE 120B
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3170
Practice Address - Country:US
Practice Address - Phone:970-622-9715
Practice Address - Fax:970-622-9736
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2547103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72152338Medicaid
CO72152338Medicaid