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General NPI Number Information
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NPI Number | 1013842491
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Entity Type | Individual
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Provider Name | CAROLINE ASHLEY DORMINY
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Gender | Female
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 5328 LANIER ISLANDS PKWY
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City | BUFORD
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State | GA
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Zip | 30518-9071
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Country | US
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Telephone | 147-065-5197
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 WOODBERRY WALK
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City | CUMMING
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State | GA
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Zip | 30028-5984
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Country | US
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Telephone | 770-318-7950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 004031
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License Number State | GA
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