Individual
MARIDEL ANDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2754 COMPASS DR, STE 170, GRAND JUNCTION, CO 81506-8714
(970) 254-1686
(970) 254-1687
Mailing address
PO BOX 234, GRAND JUNCTION, CO 81502-0234
(970) 254-1686
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2293
CO
103TC0700X
Clinical Psychologist
Primary
2293
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07022932
—
CO
Enumeration date
08/04/2006
Last updated
05/08/2013
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