Provider Demographics
NPI:1639708415
Name:BEREZENKO, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:BEREZENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLYA
Other - Middle Name:
Other - Last Name:BEREZENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2860 W 32ND AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3256
Mailing Address - Country:US
Mailing Address - Phone:916-752-1051
Mailing Address - Fax:
Practice Address - Street 1:6750 N DUNKIRK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80019-2107
Practice Address - Country:US
Practice Address - Phone:303-217-5152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist