Provider Demographics
NPI:1720184823
Name:JONSSON, MARY MARGARET (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARET
Last Name:JONSSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2855 N SPEER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4240
Mailing Address - Country:US
Mailing Address - Phone:303-830-1213
Mailing Address - Fax:303-477-5802
Practice Address - Street 1:2855 N SPEER BLVD STE D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4240
Practice Address - Country:US
Practice Address - Phone:303-830-1213
Practice Address - Fax:303-477-5802
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSYCHOLOGY1294103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical