Provider Demographics
NPI:1609300458
Name:DALGOUTTE, DORA M
Entity Type:Individual
Prefix:
First Name:DORA
Middle Name:M
Last Name:DALGOUTTE
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 1:500 ROUTE 299 STE 100B-2
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 RT.299
Practice Address - Street 2:HUDSON VALLEY BEHAVIORAL SOLUTIONS SUITE 100B-2
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2864
Practice Address - Country:US
Practice Address - Phone:845-633-0267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist