Provider Demographics
NPI:1629286380
Name:DUNAWAY, DORIS ELAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:ELAINE
Last Name:DUNAWAY
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 1:19080 SW 264TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-1787
Mailing Address - Country:US
Mailing Address - Phone:305-242-0485
Mailing Address - Fax:305-246-0019
Practice Address - Street 1:15321 S DIXIE HWY
Practice Address - Street 2:SUITE 303A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1814
Practice Address - Country:US
Practice Address - Phone:305-242-0485
Practice Address - Fax:303-246-0019
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5621103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical