Provider Demographics
NPI:1447594221
Name:DORMAN, NANCY JEAN (LAMFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEAN
Last Name:DORMAN
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 ALLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6349
Mailing Address - Country:US
Mailing Address - Phone:651-653-0387
Mailing Address - Fax:
Practice Address - Street 1:4501 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55127-6349
Practice Address - Country:US
Practice Address - Phone:651-653-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist