Provider Demographics
NPI:1871207985
Name:DOWNS, DOROTHY EPPES
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:EPPES
Last Name:DOWNS
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 1:11718 DRAYTON LANDING DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7705
Mailing Address - Country:US
Mailing Address - Phone:804-920-9496
Mailing Address - Fax:
Practice Address - Street 1:11718 DRAYTON LANDING DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7705
Practice Address - Country:US
Practice Address - Phone:804-920-9496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11482803320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities