Provider Demographics
NPI:1669503470
Name:DUNCOMBE, KELLY JO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JO
Last Name:DUNCOMBE
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 1:1801 I 70 BUSINESS LOOP STE B5
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8002
Mailing Address - Country:US
Mailing Address - Phone:970-245-3212
Mailing Address - Fax:970-245-3216
Practice Address - Street 1:1801 I 70 BUSINESS LOOP STE B5
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8002
Practice Address - Country:US
Practice Address - Phone:970-245-3212
Practice Address - Fax:970-245-3216
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY4605103TC0700X
COPSY.0000004605103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty