Healthcare Provider Details

I. General information

NPI: 1184646044
Provider Name (Legal Business Name): MARILYN SACKS-RABIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2696 S COLORADO BLVD STE 200
DENVER CO
80222
US

IV. Provider business mailing address

2696 S COLORADO BLVD STE 200
DENVER CO
80222
US

V. Phone/Fax

Practice location:
  • Phone: 303-757-1513
  • Fax: 303-692-9353
Mailing address:
  • Phone: 303-757-1513
  • Fax: 303-692-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number847
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: