Provider Demographics
NPI:1215978481
Name:DOBLER, JANET (LICSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:DOBLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 12TH AVE NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2709
Mailing Address - Country:US
Mailing Address - Phone:701-351-1934
Mailing Address - Fax:701-665-2668
Practice Address - Street 1:400 12TH AVE NE
Practice Address - Street 2:SUITE D
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2709
Practice Address - Country:US
Practice Address - Phone:701-351-1934
Practice Address - Fax:701-665-2668
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND31981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND30829OtherBCBS
ND19204Medicaid
NDN714649Medicare PIN