Provider Demographics
NPI:1730138090
Name:KIDD, STEVEN OGDEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:OGDEN
Last Name:KIDD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ECHOGLEN CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-6802
Mailing Address - Country:US
Mailing Address - Phone:719-579-5081
Mailing Address - Fax:
Practice Address - Street 1:25 N SPRUCE ST
Practice Address - Street 2:STE. 309
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1436
Practice Address - Country:US
Practice Address - Phone:719-667-5580
Practice Address - Fax:719-667-4465
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2416103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical