Provider Demographics
NPI:1427248483
Name:OT'ALORA G, MARCELA (MA)
Entity type:Individual
Prefix:MS
First Name:MARCELA
Middle Name:
Last Name:OT'ALORA G
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3931
Mailing Address - Country:US
Mailing Address - Phone:303-818-1419
Mailing Address - Fax:
Practice Address - Street 1:1844 PEARL ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5533
Practice Address - Country:US
Practice Address - Phone:303-818-1419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health