Provider Demographics
NPI:1093186108
Name:DORVILIER, IRLINDA CASSANDRA
Entity Type:Individual
Prefix:
First Name:IRLINDA
Middle Name:CASSANDRA
Last Name:DORVILIER
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 1:1760 NW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-2908
Mailing Address - Country:US
Mailing Address - Phone:786-624-7906
Mailing Address - Fax:
Practice Address - Street 1:721 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3828
Practice Address - Country:US
Practice Address - Phone:754-581-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health