Provider Demographics
NPI:1033605035
Name:DOTY, JENNIFER MARIE (MS IN PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:DOTY
Suffix:
Gender:F
Credentials:MS IN PSYCHOLOGY
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOCTORAL CANDIDATE
Mailing Address - Street 1:2225 COVERED BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:AL
Mailing Address - Zip Code:35049-4606
Mailing Address - Country:US
Mailing Address - Phone:205-446-5580
Mailing Address - Fax:
Practice Address - Street 1:103 4TH ST N STE 203
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1443
Practice Address - Country:US
Practice Address - Phone:205-305-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health