Provider Demographics
NPI:1205053378
Name:HUSTON, TOBY ALAN (PHD)
Entity type:Individual
Prefix:DR
First Name:TOBY
Middle Name:ALAN
Last Name:HUSTON
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 1:3425 S CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2811
Mailing Address - Country:US
Mailing Address - Phone:303-789-8703
Mailing Address - Fax:303-789-8327
Practice Address - Street 1:3425 S CLARKSON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2811
Practice Address - Country:US
Practice Address - Phone:303-789-8703
Practice Address - Fax:303-789-8327
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2238103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation