Provider Demographics
NPI:1376306365
Name:BUFFINGTON, DOROTHY LORRAINE
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:LORRAINE
Last Name:BUFFINGTON
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 1:2941 NW COUNTY ROAD 150
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:FL
Mailing Address - Zip Code:32052-6331
Mailing Address - Country:US
Mailing Address - Phone:386-223-7423
Mailing Address - Fax:
Practice Address - Street 1:2941 NW COUNTY ROAD 150
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:FL
Practice Address - Zip Code:32052-6331
Practice Address - Country:US
Practice Address - Phone:386-223-7423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor