Provider Demographics
NPI:1144378555
Name:GROHMANN, DOLORES B (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:B
Last Name:GROHMANN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:LOLITA
Other - Middle Name:B
Other - Last Name:GROHMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:4929 VAN DYKE RD.
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558
Mailing Address - Country:US
Mailing Address - Phone:813-924-3491
Mailing Address - Fax:813-961-5919
Practice Address - Street 1:4322 SOUTHPARK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-3417
Practice Address - Country:US
Practice Address - Phone:813-265-1105
Practice Address - Fax:813-961-4406
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1891106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist