Provider Demographics
NPI:1356506448
Name:DOAN, GARY DEAN (LMFT, MDIV)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:DEAN
Last Name:DOAN
Suffix:
Gender:M
Credentials:LMFT, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8414 E SHEA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6665
Mailing Address - Country:US
Mailing Address - Phone:480-367-1660
Mailing Address - Fax:480-367-1545
Practice Address - Street 1:8414 E SHEA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6665
Practice Address - Country:US
Practice Address - Phone:480-367-1660
Practice Address - Fax:480-367-1545
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-0055106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist