Provider Demographics
NPI:1720178395
Name:DORAY, DAWN PHELPS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:PHELPS
Last Name:DORAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 FINANCIAL CENTRE PKWY
Mailing Address - Street 2:SUITE 490
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3552
Mailing Address - Country:US
Mailing Address - Phone:501-240-1167
Mailing Address - Fax:501-228-8189
Practice Address - Street 1:10800 FINANCIAL CENTRE PKWY
Practice Address - Street 2:SUITE 490
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3552
Practice Address - Country:US
Practice Address - Phone:501-240-1167
Practice Address - Fax:501-228-8189
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR04-3P103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical