Provider Demographics
NPI:1831295922
Name:MAHLER, JEFFREY L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:MAHLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5414
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80439
Mailing Address - Country:US
Mailing Address - Phone:970-668-8324
Mailing Address - Fax:970-668-8539
Practice Address - Street 1:101 W MAIN ST
Practice Address - Street 2:# 306
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5414
Practice Address - Country:US
Practice Address - Phone:970-668-8324
Practice Address - Fax:970-668-8539
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1851103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07018518Medicaid