Provider Demographics
NPI:1639528102
Name:RIOS, GILDA OLIVIA (PHD)
Entity Type:Individual
Prefix:
First Name:GILDA
Middle Name:OLIVIA
Last Name:RIOS
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 1:1716 MAIN ST UNIT A-300
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7411
Mailing Address - Country:US
Mailing Address - Phone:720-780-9253
Mailing Address - Fax:
Practice Address - Street 1:1716 MAIN ST UNIT A-300
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7411
Practice Address - Country:US
Practice Address - Phone:720-780-9253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO0004948103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1639528102OtherUNIVERSITY COUNSELING CENTER