Provider Demographics
NPI:1255469722
Name:PRYOR, MARY ANN (CAC1, CMT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:PRYOR
Suffix:
Gender:F
Credentials:CAC1, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6012
Mailing Address - Country:US
Mailing Address - Phone:303-765-2480
Mailing Address - Fax:303-765-2492
Practice Address - Street 1:200 S SHERMAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1621
Practice Address - Country:US
Practice Address - Phone:303-765-2480
Practice Address - Fax:303-765-2492
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator