Provider Demographics
NPI:1558042416
Name:DORVIL, DOUNIA
Entity Type:Individual
Prefix:
First Name:DOUNIA
Middle Name:
Last Name:DORVIL
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 1:5361 ROSE MARIE AVE N
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-1007
Mailing Address - Country:US
Mailing Address - Phone:561-774-9236
Mailing Address - Fax:
Practice Address - Street 1:5361 ROSE MARIE AVE N
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-1007
Practice Address - Country:US
Practice Address - Phone:561-774-9236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23283834106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician