Provider Demographics
NPI:1447427331
Name:GROTE, DANA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:LEE
Last Name:GROTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 462233
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:720-231-2904
Mailing Address - Fax:720-881-8784
Practice Address - Street 1:7009 S POTOMAC ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4037
Practice Address - Country:US
Practice Address - Phone:720-231-2904
Practice Address - Fax:720-881-8784
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-11
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2629103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical