Provider Demographics
NPI:1689910176
Name:DORAMUS, HOLLY RENEE
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:RENEE
Last Name:DORAMUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:RENEE
Other - Last Name:DORAMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1408 N SUMMIT BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3034
Mailing Address - Country:US
Mailing Address - Phone:509-720-1065
Mailing Address - Fax:
Practice Address - Street 1:1408 N SUMMIT BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3034
Practice Address - Country:US
Practice Address - Phone:509-720-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health