Provider Demographics
NPI:1114138070
Name:SMITH-ACUNA, SHELLY JEANNINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:JEANNINE
Last Name:SMITH-ACUNA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:303-777-6528
Mailing Address - Fax:303-765-0350
Practice Address - Street 1:1720 S BELLAIRE ST
Practice Address - Street 2:SUITE 805
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4304
Practice Address - Country:US
Practice Address - Phone:303-765-2829
Practice Address - Fax:303-765-0350
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1684103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical