Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 1321 | CO |
Y | 102L00000X | Psychologist | 4267 | CO |
Y | 103T00000X | Psychologist | 4267 | CO |
N | 103TC1900X | Counseling Psychologist | PSY.0004267 | CO |
NPI | 1033397351 |
---|---|
Provider Name | Meryl Dohrmann |
First Address | Colorado Springs, CO 80910-2522 |
Second Address | La Junta, CO 81050-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 15/10/2019 |