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General NPI Number Information
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NPI Number | 1568777209
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Entity Type | Individual
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Provider Name | DIANA MARIE OREM PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 7601 BAD TOELZ RD 10TH SPECIAL FORCES GROUP AIRBORNE
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City | FORT CARSON
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State | CO
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Zip | 80913-4626
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Country | US
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Telephone | 710-526-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 3850 STRAWBERRY FIELD GRV APT E
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-6302
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Country | US
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Telephone | 407-461-3161
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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