Provider Demographics
NPI:1265656359
Name:MCCLOSKEY, DALENE MARIE (PH D)
Entity Type:Individual
Prefix:DR
First Name:DALENE
Middle Name:MARIE
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16473 LONGS PEAK RD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-9410
Mailing Address - Country:US
Mailing Address - Phone:970-346-7825
Mailing Address - Fax:
Practice Address - Street 1:16473 LONGS PEAK RD
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9410
Practice Address - Country:US
Practice Address - Phone:970-346-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-13-14576103K00000X
CO14071103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst