Provider Demographics
NPI:1396324687
Name:CROMIKA, DONNA RAE
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:RAE
Last Name:CROMIKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:RAE
Other - Last Name:MARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2370 SKYVIEW LN APT 220
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4833
Mailing Address - Country:US
Mailing Address - Phone:719-301-0790
Mailing Address - Fax:
Practice Address - Street 1:111 E POLK ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6267
Practice Address - Country:US
Practice Address - Phone:719-301-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist