Provider Demographics
NPI:1730214107
Name:DALLMAN, JEANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:DALLMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6059 S QUEBEC ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4514
Mailing Address - Country:US
Mailing Address - Phone:720-298-6981
Mailing Address - Fax:303-220-5064
Practice Address - Street 1:6059 S QUEBEC ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4514
Practice Address - Country:US
Practice Address - Phone:720-298-6981
Practice Address - Fax:303-220-5064
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9911941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical