MEDICARE: MRS. DONNA LEE MOLLER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2431	CO

General Provider Information

NPI Number	:	1275660722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA LEE MOLLER LPC

Provider Business Mailing Address
First Line	:	3550 S HARLAN ST # 14-289
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80235-2711
Country	:	US
Telephone Number	:	720-936-2281
Fax Number	:	866-553-0321

Provider Business Practice Location Address
First Line	:	3550 S HARLAN ST # 14-289
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80235-2711
Country	:	US
Telephone Number	:	720-936-2281
Fax Number	:	866-553-0321

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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