Healthcare Provider Details

I. General information

NPI: 1275449654
Provider Name (Legal Business Name): MACKENZIE HERMAN-OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 INVERNESS DR S STE 201
ENGLEWOOD CO
80112-6566
US

IV. Provider business mailing address

11058 E WESLEY AVE
AURORA CO
80014-1739
US

V. Phone/Fax

Practice location:
  • Phone: 303-954-9809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: