Healthcare Provider Details

I. General information

NPI: 1619304276
Provider Name (Legal Business Name): MARLYS PATTERSON MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 YATES ST
DENVER CO
80219-1034
US

IV. Provider business mailing address

163 YATES ST
DENVER CO
80219-1034
US

V. Phone/Fax

Practice location:
  • Phone: 714-269-4178
  • Fax:
Mailing address:
  • Phone: 714-269-4178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number10644
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0002858
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: