Provider Demographics
NPI:1376310284
Name:DORSEY, MARLYN
Entity Type:Individual
Prefix:MRS
First Name:MARLYN
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARLYN
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-5068
Mailing Address - Country:US
Mailing Address - Phone:732-709-7440
Mailing Address - Fax:732-709-0147
Practice Address - Street 1:220 MARKET ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-5068
Practice Address - Country:US
Practice Address - Phone:732-709-7440
Practice Address - Fax:732-709-0147
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)