Provider Demographics
NPI:1598998270
Name:BAKULSKI, DAVID RICHARD
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RICHARD
Last Name:BAKULSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7468 E PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2300
Mailing Address - Country:US
Mailing Address - Phone:303-861-0158
Mailing Address - Fax:
Practice Address - Street 1:9808 W CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1023
Practice Address - Country:US
Practice Address - Phone:303-425-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0312157700OtherHEALTHCARE PROVIDERS SERVICE ORGANIZATION