Provider Demographics
NPI:1770833725
Name:DOOLEY, JONNIE LYNN
Entity Type:Individual
Prefix:
First Name:JONNIE
Middle Name:LYNN
Last Name:DOOLEY
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 1:99 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2803
Mailing Address - Country:US
Mailing Address - Phone:702-553-7071
Mailing Address - Fax:
Practice Address - Street 1:99 WYOMING ST
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2803
Practice Address - Country:US
Practice Address - Phone:702-553-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation