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DR. DENNIS L. WACK PH.D.

Clinical Neuropsychologist

Wheat Ridge, Colorado

Provider NPI: 1487606497

Provider Information:
DR. DENNIS L. WACK PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
4045 WADSWORTH BLVD # 308 WHEAT RIDGE, CO 80033 US
Tel: 303-421-1896  Fax: 303-237-3589

Business Mailing Address:
4045 WADSWORTH BLVD # 308 WHEAT RIDGE, CO 80033 US
Tel: 303-421-1896  Fax: 303-237-3589

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CO1083
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
CO1083

Other Provider Identifiers:

IssuerNumberStateType
537078CO04
537098CO04
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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