Healthcare Provider Details
I. General information
NPI: 1568189041
Provider Name (Legal Business Name): BARBARA DORSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 BANK STREET
CLAY WV
25043
US
IV. Provider business mailing address
PO BOX 633
CLAY WV
25043-0633
US
V. Phone/Fax
- Phone: 304-587-9992
- Fax:
- Phone: 304-587-2873
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: