Provider Demographics
NPI:1790902302
Name:KRELL, MARLENE N
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:N
Last Name:KRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARLENE
Other - Middle Name:N
Other - Last Name:KALLEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1861 LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9114
Mailing Address - Country:US
Mailing Address - Phone:303-526-0881
Mailing Address - Fax:303-526-0293
Practice Address - Street 1:8795 RALSTON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2364
Practice Address - Country:US
Practice Address - Phone:303-431-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9770051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical