Healthcare Provider Details

I. General information

NPI: 1962447797
Provider Name (Legal Business Name): HENRIETTA MARY PAZOS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 S LOCUST ST STE 216
DENVER CO
80222-7132
US

IV. Provider business mailing address

11515 E AMHERST CIR N
AURORA CO
80014-3046
US

V. Phone/Fax

Practice location:
  • Phone: 303-513-1408
  • Fax:
Mailing address:
  • Phone: 303-513-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0310366
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2751
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: