Provider Demographics
NPI:1013790260
Name:BLADES, ELLE
Entity Type:Individual
Prefix:
First Name:ELLE
Middle Name:
Last Name:BLADES
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 1:8441 WILD TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-8100
Mailing Address - Country:US
Mailing Address - Phone:720-234-4168
Mailing Address - Fax:
Practice Address - Street 1:12503 E EUCLID DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6467
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician