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NPI Code Detail

MEDICARE: MARINA DORMER LMFT

MEDICARE: MARINA DORMER LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist
2106H00000XMarriage & Family Therapist93624CA

General Provider Information

NPI Number : 1336548551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARINA DORMER LMFT
Provider Business Mailing Address
First Line : 1742 OREGON ST
Second Line :
City : REDDING
State : CA
Zip : 96001-1717
Country : US
Telephone Number : 530-604-7376
Fax Number :
Provider Business Practice Location Address
First Line : 1742 OREGON ST
Second Line :
City : REDDING
State : CA
Zip : 96001-1717
Country : US
Telephone Number : 530-646-7259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 02/21/2023

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Directions to “ MARINA DORMER LMFT” Practice Location

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