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General NPI Number Information
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NPI Number | 1790574549
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Entity Type | Individual
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Provider Name | MRS. TRACY LYNN DORSETT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 101 COSTELLO DR
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City | LOOGOOTEE
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State | IN
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Zip | 47553-1433
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Country | US
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Telephone | 812-295-2833
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 637
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City | WASHINGTON
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State | IN
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Zip | 47501-0637
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Country | US
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Telephone | 812-254-1530
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Fax | 812-254-1636
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1110229
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License Number State | IN
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