Provider Demographics
NPI:1245309608
Name:MARSH, PAMELA TAYLOR (PSYD, LCSW)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:TAYLOR
Last Name:MARSH
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 GAYLORD ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1211
Mailing Address - Country:US
Mailing Address - Phone:303-316-5045
Mailing Address - Fax:303-355-2415
Practice Address - Street 1:1890 GAYLORD ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1211
Practice Address - Country:US
Practice Address - Phone:303-316-5045
Practice Address - Fax:303-355-2415
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-51041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical