Provider Demographics
NPI:1669291720
Name:DALLEY, MADALYN ELIZABETH (MA PSYD)
Entity type:Individual
Prefix:
First Name:MADALYN
Middle Name:ELIZABETH
Last Name:DALLEY
Suffix:
Gender:F
Credentials:MA PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N LOGAN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3155
Mailing Address - Country:US
Mailing Address - Phone:303-756-1197
Mailing Address - Fax:
Practice Address - Street 1:899 N LOGAN ST STE 307
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3155
Practice Address - Country:US
Practice Address - Phone:303-756-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0006532103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical