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NPI Code Detail

MEDICARE: MS. DONNA RAE CROMIKA

MEDICARE: MS. DONNA RAE CROMIKA
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1396324687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DONNA RAE CROMIKA
Provider Business Mailing Address
First Line : 2370 SKYVIEW LN APT 220
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-4833
Country : US
Telephone Number : 719-301-0790
Fax Number :
Provider Business Practice Location Address
First Line : 111 E POLK ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6267
Country : US
Telephone Number : 719-301-0790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2021
Last Update Date : 09/10/2024

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Directions to “ MS. DONNA RAE CROMIKA ” Practice Location

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