Healthcare Provider Details

I. General information

NPI: 1679799738
Provider Name (Legal Business Name): DR. MARY ANN LEVY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. MARY ANN CHUDY

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S ALBION ST SUITE 903
DENVER CO
80222-4008
US

IV. Provider business mailing address

1660 S ALBION ST SUITE 903
DENVER CO
80222-4008
US

V. Phone/Fax

Practice location:
  • Phone: 303-329-8312
  • Fax: 303-279-9552
Mailing address:
  • Phone: 303-329-8312
  • Fax: 303-279-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number18022
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: