Provider Demographics
NPI:1457066474
Name:KAMAL, DOREEN NADIA
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:NADIA
Last Name:KAMAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DOREEN
Other - Middle Name:NADIA
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32326-0694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 KING ARTHURS CT
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-8034
Practice Address - Country:US
Practice Address - Phone:850-888-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker