Provider Demographics
NPI:1184864373
Name:NEDLIN, MARNY B (PHD)
Entity Type:Individual
Prefix:
First Name:MARNY
Middle Name:B
Last Name:NEDLIN
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:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0040
Mailing Address - Country:US
Mailing Address - Phone:970-945-2241
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:0405 CASTLE CREEK RD
Practice Address - Street 2:SUITE 9
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-3125
Practice Address - Country:US
Practice Address - Phone:970-920-5555
Practice Address - Fax:970-920-5557
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000711106H00000X
CO875106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist