Provider Demographics
NPI:1528465564
Name:DORAY PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:DORAY PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DORAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:501-240-1167
Mailing Address - Street 1:212 N MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3120
Mailing Address - Country:US
Mailing Address - Phone:501-404-2077
Mailing Address - Fax:501-228-8189
Practice Address - Street 1:212 N MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3120
Practice Address - Country:US
Practice Address - Phone:501-404-2077
Practice Address - Fax:501-228-8189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR04-3P103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty