MEDICARE: MS. MARLENE N. KRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	977005	CO

General Provider Information

NPI Number	:	1790902302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARLENE N. KRELL

Provider Business Mailing Address
First Line	:	1861 LARKSPUR DR
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-9114
Country	:	US
Telephone Number	:	303-526-0881
Fax Number	:	303-526-0293

Provider Business Practice Location Address
First Line	:	8795 RALSTON RD
Second Line	:	SUITE 208
City	:	ARVADA
State	:	CO
Zip	:	80002-2364
Country	:	US
Telephone Number	:	303-431-1470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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