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General NPI Number Information
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NPI Number | 1063808798
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Entity Type | Organization
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Legal Business Name | MO SMILES LLC
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 8461 TURNPIKE DR STE 203
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City | WESTMINSTER
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State | CO
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Zip | 80031-4379
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Country | US
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Telephone | 720-627-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 8461 TURNPIKE DR SUITE #203
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City | WESTMINSTER
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State | CO
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Zip | 80031-4376
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Country | US
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Telephone | 720-277-8251
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENIFER CANDELAS
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Credential |
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Telephone | 720-277-8251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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