Provider Demographics
NPI:1568607125
Name:DORIS, ROSALYN ANN
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:ANN
Last Name:DORIS
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 1:6277 HARCROSS CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-5613
Mailing Address - Country:US
Mailing Address - Phone:352-556-4576
Mailing Address - Fax:352-556-4636
Practice Address - Street 1:6277 HARCROSS CT
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-5613
Practice Address - Country:US
Practice Address - Phone:352-556-4576
Practice Address - Fax:352-556-4636
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services