Provider Demographics
NPI:1073952032
Name:DREILING, MADYSON NICHOLE
Entity Type:Individual
Prefix:
First Name:MADYSON
Middle Name:NICHOLE
Last Name:DREILING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 W 35TH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6165
Mailing Address - Country:US
Mailing Address - Phone:303-506-9408
Mailing Address - Fax:
Practice Address - Street 1:7740 W 35TH AVE APT 306
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6165
Practice Address - Country:US
Practice Address - Phone:303-506-9408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-22
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor