Provider Demographics
NPI:1235211947
Name:DELANEY, MARY E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:DELANEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 STRICKLER RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3322
Mailing Address - Country:US
Mailing Address - Phone:719-475-8038
Mailing Address - Fax:719-475-0993
Practice Address - Street 1:1414 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7431
Practice Address - Country:US
Practice Address - Phone:719-475-8038
Practice Address - Fax:719-475-0993
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2253103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1821199803OtherNATL PROVIDER ID-TAX ID