Provider Demographics
NPI:1720750805
Name:DORSEY-WILLIAMS, MARIAN
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:DORSEY-WILLIAMS
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 1:1529 E PALMDALE BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2028
Mailing Address - Country:US
Mailing Address - Phone:661-947-1595
Mailing Address - Fax:
Practice Address - Street 1:1529 E PALMDALE BLVD STE 113
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2028
Practice Address - Country:US
Practice Address - Phone:661-947-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator