Provider Demographics
NPI:1508490335
Name:PARRIOTT, DOROTHY R (PHD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:R
Last Name:PARRIOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9611 AQUA HARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-2455
Mailing Address - Country:US
Mailing Address - Phone:201-572-0918
Mailing Address - Fax:
Practice Address - Street 1:1070 WEST HORIZON PARKWAY
Practice Address - Street 2:STE 210
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-8901
Practice Address - Country:US
Practice Address - Phone:702-405-0904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool