Provider Demographics
NPI:1780550293
Name:DORSEY, AMBER DANIELLE (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DANIELLE
Last Name:DORSEY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DANIELLE
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3439 BRIAR BRANCH TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3605
Mailing Address - Country:US
Mailing Address - Phone:850-815-8018
Mailing Address - Fax:
Practice Address - Street 1:1700 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5646
Practice Address - Country:US
Practice Address - Phone:229-400-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225A00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist