| Sandra Marie Deraney-reilly | |
|
222 W Magnolia St Fort Collins CO 80521-2812 | |
| (970) 498-0560 | |
| (970) 282-8699 |
| Full Name | Sandra Marie Deraney-reilly |
|---|---|
| Speciality | Psychologist |
| Location | 222 W Magnolia St, Fort Collins, Colorado |
| Authorized Official Name and Position | Sandra Deraney-reilly (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9704190999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra Marie Deraney-reilly 222 W Magnolia St Fort Collins CO 80521-2812 Ph: (970) 498-0560 | Sandra Marie Deraney-reilly 222 W Magnolia St Fort Collins CO 80521-2812 Ph: (970) 498-0560 |
| NPI Number | 1174091581 |
|---|---|
| Provider Enumeration Date | 11/05/2018 |
| Last Update Date | 04/22/2019 |
| Medicare PECOS PAC ID | 0941541098 |
|---|---|
| Medicare Enrollment ID | O20190418000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174091581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Sandra Marie Deraney-reilly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598815722 PECOS PAC ID: 6608118633 Enrollment ID: I20191016000580 |
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