Organization Name: | PSYCH ON HEELS |
NPI Number: | 1427284470 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHERRIE GLASSMEYER (OWNER) |
Mailing Address: | 551 Kokopelli Blvd Fruita |
State: | CO US |
Postal Code: | 815216305 |
Phone Number: | 9702541686 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2009 |
NPI Last Update Date: | 06/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 173198 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |