Provider Demographics
NPI:1346500931
Name:DOVE, JOCELYN BROOKS MAVEC (MA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:BROOKS MAVEC
Last Name:DOVE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 S SHIELDS ST # A 1/3
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4801
Mailing Address - Country:US
Mailing Address - Phone:970-232-4242
Mailing Address - Fax:
Practice Address - Street 1:1302 S SHIELDS ST # A 1/3
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4801
Practice Address - Country:US
Practice Address - Phone:970-232-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12259OtherDEPARTMENT OF REGULATORY AGENCIES