Provider Demographics
NPI:1093016636
Name:CONNER, DOROTHY M
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:M
Last Name:CONNER
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 1:6027 CASTLEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-4753
Mailing Address - Country:US
Mailing Address - Phone:702-565-4671
Mailing Address - Fax:702-565-4671
Practice Address - Street 1:3651 LINDELL RD
Practice Address - Street 2:SUITE D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1254
Practice Address - Country:US
Practice Address - Phone:702-565-4671
Practice Address - Fax:702-565-4671
Is Sole Proprietor?:No
Enumeration Date:2010-11-13
Last Update Date:2010-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor