Basic Information
| Provider Information | |||||||||
| NPI: | 1104584010 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMULIC | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | ELENA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1870 W 122ND AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802342075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038533500 | ||||||||
| FaxNumber: | 3038533702 | ||||||||
| Practice Location | |||||||||
| Address1: | 8989 HURON ST | ||||||||
| Address2: | |||||||||
| City: | THORNTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802606858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038533500 | ||||||||
| FaxNumber: | 3038533702 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2021 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 0002075 | CO | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | MFT.0002075 | CO | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.