Provider Demographics
NPI:1750348744
Name:GUERRANT, DORIS (PH D)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:GUERRANT
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 BREMBLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-2530
Mailing Address - Country:US
Mailing Address - Phone:540-721-1818
Mailing Address - Fax:540-721-0048
Practice Address - Street 1:1525 BREMBLE DR
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-2530
Practice Address - Country:US
Practice Address - Phone:540-721-1818
Practice Address - Fax:540-721-0048
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
000619OtherVALUE OPTIONS
VA026322OtherANTHEM
VA142941OtherANTHEM