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General NPI Number Information
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NPI Number | 1922512888
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Entity Type | Organization
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Legal Business Name | DEBORAH DORRIS LPC LLC
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 6249 US HIGHWAY 231
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City | WETUMPKA
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State | AL
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Zip | 36092-2831
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Country | US
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Telephone | 334-676-3488
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Fax | 334-245-0156
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Provider Business Mailing Address
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Address Line | PO BOX 101
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City | WETUMPKA
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State | AL
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Zip | 36092-0002
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Country | US
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Telephone | 334-676-3488
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Fax | 334-245-0156
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. DEBORAH SUE DORRIS
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Credential | LPC
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Telephone | 334-676-3488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1384
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License Number State | AL
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