Provider Demographics
NPI:1962647099
Name:DE LALIO, LAURIE (CNS)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:DE LALIO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 W 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3807
Mailing Address - Country:US
Mailing Address - Phone:303-561-5010
Mailing Address - Fax:303-561-5050
Practice Address - Street 1:2551 W 84TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3807
Practice Address - Country:US
Practice Address - Phone:303-561-5010
Practice Address - Fax:303-561-5050
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004466163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17155100Medicaid
COP01419467OtherMCR RAILROAD
CO316096YLTTMedicare UPIN
CO316096YMMWMedicare UPIN