1467576454 NPI number — DR. RUTH R HOOLEY MSRN PHD PSYD

Table of content: DR. RUTH R HOOLEY MSRN PHD PSYD (NPI 1467576454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467576454 NPI number — DR. RUTH R HOOLEY MSRN PHD PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOLEY
Provider First Name:
RUTH
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MSRN PHD PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467576454
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8971 CROSSINGTON WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONETREE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80124-5583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-798-8887
Provider Business Mailing Address Fax Number:
303-798-8887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1776 S JACKSON ST
Provider Second Line Business Practice Location Address:
#618
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80210-3801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-649-6685
Provider Business Practice Location Address Fax Number:
303-798-8887
Provider Enumeration Date:
03/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  1953 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07019532 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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