| Doctor Name: | MALLORI KENWORTHY |
| NPI Number: | 1013252857 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | NLC.013225 |
| Business Practice Address: | 10093 Salida St Commerce City, CO - 800228844 |
| Business Phone Number: | 7209398477 |
| Business Fax Number: | |
| Mailing Address: | 10093 Salida Street, COMMERCE CITY |
| State: | CO |
| Postal Code: | 80022 |
| Phone Number: | 7209398477 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2012 |
| NPI Last Update Date: | 12/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | NLC.013225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |