Individual
KATHLEEN E DORSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IMFT
Contact information
Practice address
37 IRONGATE PARK DR, CENTERVILLE, OH 45459
(937) 907-0393
Mailing address
37 IRONGATE PARK DR, CENTERVILLE, OH 45459-4616
(937) 907-0393
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
F.1500013
OH
106H00000X
Marriage & Family Therapist
Primary
F.1500013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
OHIO DEPT. ALCOHOL DRUG ADDICTION SERVICES (ODADAS) GROUP
OH
01
—
0074946
OHIO DEPT. MENTAL HEALTH (GROUP)
OH
01
—
01-0693
CARF CERTIFICATION
OH
01
—
H130910
MEDICARE GROUP PTAN
OH
Enumeration date
10/21/2015
Last updated
06/25/2018
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