Provider Demographics
NPI:1477899284
Name:ASHER, DORIAN W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DORIAN
Middle Name:W
Last Name:ASHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S PARK AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-3627
Mailing Address - Country:US
Mailing Address - Phone:866-437-7924
Mailing Address - Fax:
Practice Address - Street 1:101 S PARK AVE STE 8
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3627
Practice Address - Country:US
Practice Address - Phone:866-437-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-203361103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical