Provider Demographics
NPI:1932327467
Name:RANCH, GARY STANLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:STANLEY
Last Name:RANCH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:375 E HORSETOOTH RD
Mailing Address - Street 2:BUILDING 3, SUITE 201
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3155
Mailing Address - Country:US
Mailing Address - Phone:970-223-0356
Mailing Address - Fax:970-204-9767
Practice Address - Street 1:375 E HORSETOOTH RD
Practice Address - Street 2:BUILDING 3, SUITE 201
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3155
Practice Address - Country:US
Practice Address - Phone:970-223-0356
Practice Address - Fax:970-204-9767
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1564103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical