Provider Demographics
NPI:1609262732
Name:DORAN, ANDREA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIA
Last Name:DORAN
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 1:1812 MARIAN AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2632
Mailing Address - Country:US
Mailing Address - Phone:775-841-0917
Mailing Address - Fax:
Practice Address - Street 1:755 N ROOP ST
Practice Address - Street 2:STE. 101
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3113
Practice Address - Country:US
Practice Address - Phone:775-841-6050
Practice Address - Fax:775-841-6053
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist