Provider Demographics
NPI:1043248313
Name:SKALICKY, AARON EMIL (PHD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:EMIL
Last Name:SKALICKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E HARMONY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3210
Mailing Address - Country:US
Mailing Address - Phone:970-282-4428
Mailing Address - Fax:970-282-4393
Practice Address - Street 1:608 E HARMONY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3210
Practice Address - Country:US
Practice Address - Phone:970-282-4428
Practice Address - Fax:970-282-4393
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2843103TB0200X, 103TC0700X, 103TC2200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities