Provider Demographics
NPI:1275587321
Name:COLAVITA, DOROTHEA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHEA
Middle Name:
Last Name:COLAVITA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DOROTHEA
Other - Middle Name:
Other - Last Name:DEL CASINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1761 DOLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 S DELAWARE AVE
Practice Address - Street 2:SUITE 203B-2
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1524
Practice Address - Country:US
Practice Address - Phone:215-208-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-16014103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling