Individual
MARK NEIL FARACO-HADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
445 UNION BLVD, SUITE 238, LAKEWOOD, CO 80228-1237
(303) 988-1089
(303) 816-0194
Mailing address
PO BOX 280772, LAKEWOOD, CO 80228-0772
(303) 988-1089
(303) 816-0194
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1571
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07015712
—
CO
Enumeration date
11/26/2005
Last updated
07/07/2010
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