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General NPI Number Information
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NPI Number | 1396051108
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Entity Type | Individual
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Provider Name | ADRIENNE N DOUBRAVA PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 405 S WILCOX ST STE 104
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1957
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Country | US
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Telephone | 720-323-8634
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S WILCOX ST PMB 142
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1913
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Country | US
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Telephone | 720-323-8634
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY0005447
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License Number State | CO
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