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Individual

MAREK C DVORAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
6610 GUNPARK DR, SUITE 101B, BOULDER, CO 80301-3460
(720) 636-4409
Mailing address
6610 GUNPARK DR, SUITE 101B, BOULDER, CO 80301-3460
(720) 636-4409

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY0004303
CO
103TC0700X
Clinical Psychologist
PSY27642
CA

Other

Enumeration date
10/26/2011
Last updated
04/05/2016
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