Provider Demographics
NPI:1366952525
Name:GIANGRASSO-COLICCHIO, NICOL M (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOL
Middle Name:M
Last Name:GIANGRASSO-COLICCHIO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 WHALERS WAY STE C100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3373
Mailing Address - Country:US
Mailing Address - Phone:970-691-8877
Mailing Address - Fax:
Practice Address - Street 1:760 WHALERS WAY STE C100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3373
Practice Address - Country:US
Practice Address - Phone:970-691-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities