Individual
MARK G PENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3015 47TH STREET SUITE E-3, BOULDER, CO 80301-5437
(303) 444-6335
(303) 443-9641
Mailing address
3015 47TH STREET SUITE E-3, BOULDER, CO 80301-5437
(303) 444-6335
(303) 443-9641
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
797
CO
103TC0700X
Clinical Psychologist
797
CO
103TF0200X
Forensic Psychologist
797
CO
103TR0400X
Rehabilitation Psychologist
797
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07106081
—
CO
Enumeration date
01/30/2006
Last updated
07/23/2007
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