Provider Demographics
NPI:1245053842
Name:DORADO, KRISTIE JO (MED)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:JO
Last Name:DORADO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19805 COAL HERITAGE RD
Mailing Address - Street 2:
Mailing Address - City:WELCH
Mailing Address - State:WV
Mailing Address - Zip Code:24801-2954
Mailing Address - Country:US
Mailing Address - Phone:304-436-2106
Mailing Address - Fax:304-436-2107
Practice Address - Street 1:19805 COAL HERITAGE RD
Practice Address - Street 2:
Practice Address - City:WELCH
Practice Address - State:WV
Practice Address - Zip Code:24801-2954
Practice Address - Country:US
Practice Address - Phone:304-436-2106
Practice Address - Fax:304-436-6362
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor