Provider Demographics
NPI:1982032090
Name:DOERRER, DORIS VIVIANA (LSW)
Entity Type:Individual
Prefix:MISS
First Name:DORIS
Middle Name:VIVIANA
Last Name:DOERRER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 VALLEYSCENT AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1170
Mailing Address - Country:US
Mailing Address - Phone:908-208-0692
Mailing Address - Fax:
Practice Address - Street 1:340 VALLEYSCENT AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1170
Practice Address - Country:US
Practice Address - Phone:908-208-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05013500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker