Provider Demographics
NPI:1134337330
Name:DEBRA L. ANDERSON, PH.D., P.C.
Entity type:Organization
Organization Name:DEBRA L. ANDERSON, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-565-2544
Mailing Address - Street 1:954 NORTH ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3307
Mailing Address - Country:US
Mailing Address - Phone:720-565-2544
Mailing Address - Fax:720-565-8444
Practice Address - Street 1:954 NORTH ST
Practice Address - Street 2:SUITE 308
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3307
Practice Address - Country:US
Practice Address - Phone:720-565-2544
Practice Address - Fax:720-565-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1650103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty