Healthcare Provider Details

I. General information

NPI: 1942120043
Provider Name (Legal Business Name): ELLEN AAL PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 WALNUT ST STE 204
BOULDER CO
80302-5753
US

IV. Provider business mailing address

3832 S TORREYS PEAK DR
SUPERIOR CO
80027-6111
US

V. Phone/Fax

Practice location:
  • Phone: 303-732-5423
  • Fax:
Mailing address:
  • Phone: 720-470-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1629744
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: