Provider Demographics
NPI:1750373569
Name:LIGGETT, ANI S (PHD)
Entity type:Individual
Prefix:DR
First Name:ANI
Middle Name:S
Last Name:LIGGETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 ARTEMIS CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2828
Mailing Address - Country:US
Mailing Address - Phone:303-664-0243
Mailing Address - Fax:
Practice Address - Street 1:740 BURBANK ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1658
Practice Address - Country:US
Practice Address - Phone:720-771-7730
Practice Address - Fax:303-664-0243
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2386103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4669Medicare PIN