Provider Demographics
NPI:1073196812
Name:PHILBERT, DOSSLEY A
Entity Type:Individual
Prefix:
First Name:DOSSLEY
Middle Name:A
Last Name:PHILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 WEAVER WAY
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-3154
Mailing Address - Country:US
Mailing Address - Phone:336-417-4067
Mailing Address - Fax:
Practice Address - Street 1:5842 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6293
Practice Address - Country:US
Practice Address - Phone:919-572-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0154751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical