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General NPI Number Information
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NPI Number | 1285134643
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Entity Type | Individual
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Provider Name | KELLY DORSEY
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Gender | Female
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 4336 NORTH BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70806-3920
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Country | US
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Telephone | 225-289-3059
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Fax |
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Provider Business Mailing Address
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Address Line | 550 LEE DR APT 215
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City | BATON ROUGE
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State | LA
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Zip | 70808-8902
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Country | US
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Telephone | 504-610-3374
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8637
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License Number State | LA
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