Individual
DYLAN MACKIE-HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5801 W ALAMEDA AVE, LAKEWOOD, CO 80226
(303) 425-0300
(303) 432-5071
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC.0014487
CO
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
01/04/2016
Last updated
06/08/2018
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