Provider Demographics
NPI:1164238671
Name:MULLANEY, ROXANA CECILIA (CCHI)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:CECILIA
Last Name:MULLANEY
Suffix:
Gender:F
Credentials:CCHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2073
Mailing Address - Country:US
Mailing Address - Phone:970-689-4333
Mailing Address - Fax:
Practice Address - Street 1:1600 SPECHT POINT RD STE 115
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4311
Practice Address - Country:US
Practice Address - Phone:970-689-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171R00000X171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter