Provider Demographics
NPI:1669682423
Name:DENICORE, MOLLY RAE
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:RAE
Last Name:DENICORE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:RAE
Other - Last Name:DENICORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, MA
Mailing Address - Street 1:3724 PECOS TRL
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-4595
Mailing Address - Country:US
Mailing Address - Phone:303-815-9050
Mailing Address - Fax:
Practice Address - Street 1:3724 PECOS TRL
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-4595
Practice Address - Country:US
Practice Address - Phone:303-815-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist