Provider Demographics
NPI:1801683354
Name:PAYAN, MARISOL
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:PAYAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 W LONG DR APT 266
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1234
Mailing Address - Country:US
Mailing Address - Phone:720-636-4142
Mailing Address - Fax:
Practice Address - Street 1:8012 W LONG DR APT 266
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-1234
Practice Address - Country:US
Practice Address - Phone:720-636-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter