Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 19464 | CO |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 19464 | CO |
NPI | 1356579965 |
---|---|
Provider Name | Dr. Dawn Victoria Obrecht |
First Address | Steamboat Springs, CO 80477-5596 |
Second Address | Steamboat Springs, CO 80487-9447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 23/06/2009 |