Provider Demographics
NPI:1538443106
Name:LOHRENTZ, MAURA LEIGH
Entity type:Individual
Prefix:MISS
First Name:MAURA
Middle Name:LEIGH
Last Name:LOHRENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 S 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5501
Mailing Address - Country:US
Mailing Address - Phone:970-331-9082
Mailing Address - Fax:
Practice Address - Street 1:85 S 38TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5501
Practice Address - Country:US
Practice Address - Phone:970-331-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist