Provider Demographics
NPI:1851919732
Name:BOTTE, MARY ANNE (MFTC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:BOTTE
Suffix:
Gender:F
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 N QUEBEC ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7358
Mailing Address - Country:US
Mailing Address - Phone:303-717-4623
Mailing Address - Fax:
Practice Address - Street 1:63 N QUEBEC ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7357
Practice Address - Country:US
Practice Address - Phone:720-414-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002377106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist