Provider Demographics
NPI:1801091228
Name:MAREK, SHARLA ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARLA
Middle Name:ANNE
Last Name:MAREK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:CO
Mailing Address - Zip Code:81069-0812
Mailing Address - Country:US
Mailing Address - Phone:719-557-2025
Mailing Address - Fax:719-489-3273
Practice Address - Street 1:2113 MAIN STREET
Practice Address - Street 2:SUITE D
Practice Address - City:RYE
Practice Address - State:CO
Practice Address - Zip Code:81069
Practice Address - Country:US
Practice Address - Phone:719-557-2025
Practice Address - Fax:719-489-3273
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-16
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2944103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist