Basic Information
| Provider Information | |||||||||
| NPI: | 1932452232 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DORNISCH | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10200 PARK MEADOWS DR | ||||||||
| Address2: | #425- | ||||||||
| City: | LONETREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801245456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035136829 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5500 S SYCAMORE ST | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801208201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037979440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2012 | ||||||||
| LastUpdateDate: | 10/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
No ID Information.