Provider Demographics
NPI:1093513988
Name:DORN504-338-0888, JOAN DEMETRICE
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:DEMETRICE
Last Name:DORN504-338-0888
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 WESTBANK EXPY STE B
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2304
Mailing Address - Country:US
Mailing Address - Phone:504-265-0801
Mailing Address - Fax:
Practice Address - Street 1:7606 WESTBANK EXPY STE B
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2304
Practice Address - Country:US
Practice Address - Phone:504-265-0801
Practice Address - Fax:504-265-8201
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator