Healthcare Provider Details

I. General information

NPI: 1093570228
Provider Name (Legal Business Name): ARISSA D DORSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3918 POTEE ST
BALTIMORE MD
21225-1724
US

IV. Provider business mailing address

5202 HILLWELL RD
BALTIMORE MD
21229-3225
US

V. Phone/Fax

Practice location:
  • Phone: 443-813-8292
  • Fax:
Mailing address:
  • Phone: 443-813-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: