Provider Demographics
NPI:1568172013
Name:COLEEN DOBO PSYD LLC
Entity Type:Organization
Organization Name:COLEEN DOBO PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-372-9437
Mailing Address - Street 1:11 WALTS HL
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1202
Mailing Address - Country:US
Mailing Address - Phone:860-372-9437
Mailing Address - Fax:
Practice Address - Street 1:11 WALTS HL
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1202
Practice Address - Country:US
Practice Address - Phone:860-372-9437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty