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General NPI Number Information
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NPI Number | 1891144127
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Entity Type | Individual
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Provider Name | BERNADETTE DORR PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 1000 E BROAD ST SUITE 200
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City | COLUMBUS
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State | OH
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Zip | 43205-1381
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Country | US
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Telephone | 614-834-0586
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Fax |
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Provider Business Mailing Address
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Address Line | 121 COBBLESTONE AVE E
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City | WESTERVILLE
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State | OH
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Zip | 43081-4587
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Country | US
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Telephone | 614-805-7638
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4978
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License Number State | OH
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