Provider Demographics
NPI:1215182969
Name:CAIATI, MARY ELLEN
Entity Type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:CAIATI
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 1:4495 HALE PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6203
Mailing Address - Country:US
Mailing Address - Phone:303-860-8640
Mailing Address - Fax:303-863-1913
Practice Address - Street 1:4495 HALE PKWY STE 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6203
Practice Address - Country:US
Practice Address - Phone:303-860-8640
Practice Address - Fax:303-863-1913
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO331902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry