Provider Demographics
NPI:1063842375
Name:DORLAND, JESSICA (MS MED LPC DBH)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:DORLAND
Suffix:
Gender:F
Credentials:MS MED LPC DBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E UNIVERSITY BLVD STE 142
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7998
Mailing Address - Country:US
Mailing Address - Phone:520-302-4116
Mailing Address - Fax:
Practice Address - Street 1:3900 E TIMROD ST # 7
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4170
Practice Address - Country:US
Practice Address - Phone:520-302-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-14423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional