Provider Demographics
NPI:1861665804
Name:GUZZO, MARLA SUE
Entity type:Individual
Prefix:MS
First Name:MARLA
Middle Name:SUE
Last Name:GUZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 BLUFF ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2104
Mailing Address - Country:US
Mailing Address - Phone:303-330-3328
Mailing Address - Fax:
Practice Address - Street 1:3002 BLUFF ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2104
Practice Address - Country:US
Practice Address - Phone:720-470-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist