Provider Demographics
NPI:1629220645
Name:DUCOTE-SABEY, DIANNA GWENDOLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:GWENDOLYN
Last Name:DUCOTE-SABEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 W 38TH AVE
Mailing Address - Street 2:STE 9
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80212-7173
Mailing Address - Country:US
Mailing Address - Phone:720-560-1450
Mailing Address - Fax:720-370-3381
Practice Address - Street 1:5810 W 38TH AVE
Practice Address - Street 2:STE 9
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80212-7173
Practice Address - Country:US
Practice Address - Phone:720-560-1450
Practice Address - Fax:720-370-3381
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2626103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2626OtherPSYCHOLOLGIST LICENSE