Provider Demographics
NPI:1447086525
Name:MORONEY, KRYSTAL JOY (PHD)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:JOY
Last Name:MORONEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E 12TH AVE APT 15
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2784
Mailing Address - Country:US
Mailing Address - Phone:586-871-5959
Mailing Address - Fax:
Practice Address - Street 1:2727 BRYANT ST STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4152
Practice Address - Country:US
Practice Address - Phone:720-398-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15539103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical