Provider Demographics
NPI:1114247178
Name:BARTLESON, DOROTHY MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:MICHELLE
Last Name:BARTLESON
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 1:980 SOUTH IOWA AVENUE
Mailing Address - Street 2:FOUR OAKS
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50402
Mailing Address - Country:US
Mailing Address - Phone:641-423-3222
Mailing Address - Fax:641-423-1740
Practice Address - Street 1:980 SOUTH IOWA AVENUE
Practice Address - Street 2:FOUR OAKS
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50402
Practice Address - Country:US
Practice Address - Phone:641-423-3222
Practice Address - Fax:641-423-1740
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001279101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health