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General NPI Number Information
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NPI Number | 1649700915
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Entity Type | Individual
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Provider Name | DORA TIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/16/2024
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Provider Practice Location Address
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Address Line | 300 CRITTENDEN BLVD
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City | ROCHESTER
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State | NY
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Zip | 14642-5215
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Country | US
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Telephone | 910-332-5734
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Fax |
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Provider Business Mailing Address
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Address Line | 211 S CENTENNIAL ST
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City | HIGH POINT
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State | NC
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Zip | 27260-5215
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C012262
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW020897
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2002074
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 116672
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License Number State | NY
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