Healthcare Provider Details

I. General information

NPI: 1073439709
Provider Name (Legal Business Name): MARY F CREPEAU-HOBSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LAWRENCE ST
DENVER CO
80204-2029
US

IV. Provider business mailing address

1380 LAWRENCE ST
DENVER CO
80204-2029
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-6315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2316
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: