Healthcare Provider Details

I. General information

NPI: 1972749463
Provider Name (Legal Business Name): DAVID GEORGE DELANEY L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2009
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9236 CLARE COURT
BOULDER CO
80303-1606
US

IV. Provider business mailing address

9236 CLARE CT
BOULDER CO
80303-1606
US

V. Phone/Fax

Practice location:
  • Phone: 303-449-2004
  • Fax:
Mailing address:
  • Phone: 303-449-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4737
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number4737
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: