Provider Demographics
NPI:1366261125
Name:ENGELE, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ENGELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 DARLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6027
Mailing Address - Country:US
Mailing Address - Phone:720-272-9720
Mailing Address - Fax:
Practice Address - Street 1:720 100 YEARPARTY CT STE 200
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-8591
Practice Address - Country:US
Practice Address - Phone:720-295-7427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health