Provider Demographics
NPI:1952876302
Name:DOTSON, VERONICA A (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:DOTSON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WALLS DR STE 206
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5180
Mailing Address - Country:US
Mailing Address - Phone:203-689-8989
Mailing Address - Fax:
Practice Address - Street 1:55 WALLS DR STE 206
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5180
Practice Address - Country:US
Practice Address - Phone:203-689-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.2200298106H00000X
CT3353106H00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist