Provider Demographics
NPI:1912732777
Name:SWITCHBACK PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:SWITCHBACK PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUTISTA-BIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:914-886-2190
Mailing Address - Street 1:1800 30TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1087
Mailing Address - Country:US
Mailing Address - Phone:720-340-3441
Mailing Address - Fax:
Practice Address - Street 1:1800 30TH ST STE 212
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1087
Practice Address - Country:US
Practice Address - Phone:720-340-3441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty