| J. Blair Cano, Psyd, Mscp | |
|
77 3rd St # 400 Monument CO 80132-8179 | |
| (719) 964-8953 | |
| Not Available |
| Full Name | J. Blair Cano, Psyd, Mscp |
|---|---|
| Speciality | Psychologist |
| Location | 77 3rd St # 400, Monument, Colorado |
| Authorized Official Name and Position | Jessica Hetrick-cano (OWNER) |
| Authorized Official Contact | 7199648953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Blair Cano, Psyd, Mscp 1938 Wood Ave Colorado Springs CO 80907-6715 Ph: (719) 964-8953 | J. Blair Cano, Psyd, Mscp 77 3rd St # 400 Monument CO 80132-8179 Ph: (719) 964-8953 |
| NPI Number | 1689282444 |
|---|---|
| Provider Enumeration Date | 07/17/2020 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Medicare PECOS PAC ID | 1557788312 |
|---|---|
| Medicare Enrollment ID | O20200826000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689282444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica B Hetrick-cano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730444142 PECOS PAC ID: 2466879226 Enrollment ID: I20200826000287 |
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