Provider Demographics
NPI:1972686624
Name:METHNER, DAMARIS HOYL (PHD)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:HOYL
Last Name:METHNER
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:PO BOX 2080
Mailing Address - Street 2:22649 PEAK TO PEAK HIGHWAY 119
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-2080
Mailing Address - Country:US
Mailing Address - Phone:303-258-1599
Mailing Address - Fax:
Practice Address - Street 1:4410 ARAPAHOE AVE
Practice Address - Street 2:#130
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1193
Practice Address - Country:US
Practice Address - Phone:303-415-2047
Practice Address - Fax:303-415-2500
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC808135Medicare PIN