Provider Demographics
NPI:1982272431
Name:FORCHU, DOROTHY CHIABI (NP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CHIABI
Last Name:FORCHU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8032 BRANCH HOLLOW TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-5002
Mailing Address - Country:US
Mailing Address - Phone:817-724-2451
Mailing Address - Fax:
Practice Address - Street 1:SOUTHWEST BEHAVIORAL SERVICES INC
Practice Address - Street 2:1601 W DESERT COVE AVE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:602-943-0726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ257863363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health