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General NPI Number Information
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NPI Number | 1255839882
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Entity Type | Individual
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Provider Name | ANNA O MAYER MA, R-DMT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 8774 YATES DR STE 305A
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City | WESTMINSTER
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State | CO
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Zip | 80031-6971
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Country | US
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Telephone | 248-462-4484
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Fax |
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Provider Business Mailing Address
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Address Line | 5110 WILLIAMS FORK TRL APT 103
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City | BOULDER
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State | CO
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Zip | 80301-3407
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Country | US
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Telephone | 248-462-4484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | R-DMT-2287
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NLC.0106321
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License Number State | CO
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