Provider Demographics
NPI:1497483036
Name:DOLIN, JULIE ELISABETH (MA, LPC, BC-DMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELISABETH
Last Name:DOLIN
Suffix:
Gender:F
Credentials:MA, LPC, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4744
Mailing Address - Country:US
Mailing Address - Phone:720-936-0925
Mailing Address - Fax:
Practice Address - Street 1:820 PINE ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4744
Practice Address - Country:US
Practice Address - Phone:720-936-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BC-DMT-888225600000X
CO0001181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist