Provider Demographics
NPI:1134462088
Name:DOTSON, BILLIE JOANN
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JOANN
Last Name:DOTSON
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 1:9200 DOUBLE R BLVD UNIT 1032
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-9022
Mailing Address - Country:US
Mailing Address - Phone:702-489-1821
Mailing Address - Fax:702-823-4781
Practice Address - Street 1:9200 DOUBLE R BLVD UNIT 1032
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-9022
Practice Address - Country:US
Practice Address - Phone:702-489-1821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV103K00000XMedicaid