Provider Demographics
NPI:1467948083
Name:DORAND, CAMILLA
Entity Type:Individual
Prefix:
First Name:CAMILLA
Middle Name:
Last Name:DORAND
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 1:12317 FANWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-4613
Mailing Address - Country:US
Mailing Address - Phone:702-762-5030
Mailing Address - Fax:
Practice Address - Street 1:2801 S VALLEY VIEW BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0166
Practice Address - Country:US
Practice Address - Phone:702-922-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health