Provider Demographics
NPI:1942653456
Name:KROMENACKER, MELODY ANN
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ANN
Last Name:KROMENACKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S ONEIDA ST
Mailing Address - Street 2:APT 16-301
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224
Mailing Address - Country:US
Mailing Address - Phone:303-746-2109
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health