Provider Demographics
NPI:1609069277
Name:SHAPIRO, MARLA ALIZA ZEIDERMAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:ALIZA ZEIDERMAN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:A
Other - Last Name:ZEIDERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5555 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2312
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3250103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO024135OtherKAISER COMMERCIAL NUMBER
CO96773863Medicaid
CO96773863Medicaid