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General NPI Number Information
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NPI Number | 1174583256
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Entity Type | Individual
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Provider Name | SUSAN J DORSKY MA, PHD, LSW
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1375 COMMERCE DR
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City | NEW LEXINGTON
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State | OH
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Zip | 43764-9511
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Country | US
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Telephone | 740-454-9766
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Fax | 740-588-6452
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Provider Business Mailing Address
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Address Line | 201 MCKINLEY AVE
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City | NEW LEXINGTON
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State | OH
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Zip | 43764-1434
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Country | US
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Telephone | 740-342-3868
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S0013210
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License Number State | OH
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