Provider Demographics
NPI:1326601790
Name:RICHARDSON, DORIAN LORRAE (ND)
Entity type:Individual
Prefix:DR
First Name:DORIAN
Middle Name:LORRAE
Last Name:RICHARDSON
Suffix:
Gender:
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 E RAY RD UNIT 1915
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-4591
Mailing Address - Country:US
Mailing Address - Phone:520-505-1944
Mailing Address - Fax:
Practice Address - Street 1:205 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2327
Practice Address - Country:US
Practice Address - Phone:520-505-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1799175F00000X, 207Q00000X, 2084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry