Individual
JESSICA DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
1504 HARPER RD, BECKLEY, WV 25801-3308
(304) 719-7536
Mailing address
1504 HARPER RD, BECKLEY, WV 25801-3308
(304) 719-7536
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-9112
WV
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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