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General NPI Number Information
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NPI Number | 1417098781
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Entity Type | Organization
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Legal Business Name | ADRIENNE MARKS PHD P.C.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 225 EAST 2ND STREET
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City | SALIDA
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State | CO
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Zip | 81201
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Country | US
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Telephone | 719-539-6160
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Fax | 719-539-7151
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Provider Business Mailing Address
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Address Line | PO BOX 1411
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City | SALIDA
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State | CO
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Zip | 81201
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Country | US
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Telephone | 719-539-6160
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Fax | 719-539-7151
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Authorized Official
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Title or Position | OWNER
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Name | ADRIENNE K MARKS
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Credential | PH.D
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Telephone | 719-539-6160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1364
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License Number State | CO
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