Provider Demographics
NPI:1417781592
Name:DOHSE, KIRA MARIE
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:MARIE
Last Name:DOHSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 W YELLOWSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-4299
Mailing Address - Country:US
Mailing Address - Phone:480-254-1384
Mailing Address - Fax:
Practice Address - Street 1:4840 E ADOBE ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-5391
Practice Address - Country:US
Practice Address - Phone:480-472-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP15614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist