Doctor Name: | DR. JASON MICHAEL NUPP |
NPI Number: | 1538386727 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 3072 |
Business Practice Address: | 900 Potomac St Aurora, CO - 800116716 |
Business Phone Number: | 3033635134 |
Business Fax Number: | 3033635168 |
Mailing Address: | 747 S Downing St, DENVER |
State: | CO |
Postal Code: | 802094434 |
Phone Number: | 3033337365 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 3072 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |