Provider Demographics
NPI:1841965753
Name:THURNER-MARTIN, DOROTHEA (MA, MS, LAC)
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:
Last Name:THURNER-MARTIN
Suffix:
Gender:F
Credentials:MA, MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 PATTERSON RD UNIT 16
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1100
Mailing Address - Country:US
Mailing Address - Phone:970-778-3030
Mailing Address - Fax:855-203-0839
Practice Address - Street 1:2472 PATTERSON RD UNIT 16
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1100
Practice Address - Country:US
Practice Address - Phone:970-778-3030
Practice Address - Fax:855-203-0839
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2364-01101YM0800X
CO2364-00101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health