Healthcare Provider Details

I. General information

NPI: 1255684320
Provider Name (Legal Business Name): DOLLMARIE ADORNO RONDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 S STAPLEY DR STE 209
MESA AZ
85204-6679
US

IV. Provider business mailing address

950 E SOUTHERN AVE APT 133
MESA AZ
85204-5037
US

V. Phone/Fax

Practice location:
  • Phone: 480-351-8020
  • Fax:
Mailing address:
  • Phone: 787-678-7134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19734
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: