Provider Demographics
NPI:1760144869
Name:DOOLEN, AUBREY RENEE
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:RENEE
Last Name:DOOLEN
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 1:2511 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2073
Mailing Address - Country:US
Mailing Address - Phone:816-489-9832
Mailing Address - Fax:
Practice Address - Street 1:2511 W 31ST ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2073
Practice Address - Country:US
Practice Address - Phone:816-489-9832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program