Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1934 | CO |
N | 103T00000X | Psychologist | 1934 | CO |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1934 | CO |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1934 | CO |
N | 103G00000X | Clinical Psychologist | 1934 | CO |
N | 103TC0700X | Clinical Psychologist | 1934 | CO |
N | 103TC1900X | Counseling Psychologist | 1934 | CO |
N | 103TF0000X | Family Psychologist | 1934 | CO |
NPI | 1134119126 |
---|---|
Provider Name | Dr. Mark A Rush |
First Address | Denver, CO 80203-3506 |
Second Address | Denver, CO 80203-3506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 08/07/2007 |