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General NPI Number Information
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NPI Number | 1346597887
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Entity Type | Individual
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Provider Name | MALLORIE DANIELLE SMOLEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 1269 CLEVELAND AVE STE 2
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City | LOVELAND
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State | CO
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Zip | 80537-4724
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Country | US
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Telephone | 970-573-1655
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Fax | 855-217-8024
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Provider Business Mailing Address
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Address Line | 2950 MOUNTAIN LION DR APT 107
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City | LOVELAND
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State | CO
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Zip | 80537-8965
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Country | US
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Telephone | 970-573-1655
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Fax | 855-217-8024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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