Healthcare Provider Details

I. General information

NPI: 1497671267
Provider Name (Legal Business Name): BRIANA DOTSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13721 S LOWE AVE
RIVERDALE IL
60827-1129
US

IV. Provider business mailing address

13721 S LOWE AVE
RIVERDALE IL
60827-1129
US

V. Phone/Fax

Practice location:
  • Phone: 708-501-2907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: