Provider Demographics
NPI:1316250053
Name:ANNE DORRE, PHD, LLC
Entity type:Organization
Organization Name:ANNE DORRE, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-634-0569
Mailing Address - Street 1:4919 PEPELANI LOOP APT 8C
Mailing Address - Street 2:
Mailing Address - City:PRINCEVILLE
Mailing Address - State:HI
Mailing Address - Zip Code:96722-5357
Mailing Address - Country:US
Mailing Address - Phone:808-634-0569
Mailing Address - Fax:
Practice Address - Street 1:4566 OHIA ST
Practice Address - Street 2:SUITE D
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1646
Practice Address - Country:US
Practice Address - Phone:808-634-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1170261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)