Provider Demographics
NPI:1871310516
Name:DORSETT, LAUREN CRISTINA
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CRISTINA
Last Name:DORSETT
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 1:1004 NORMA LN
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3828
Mailing Address - Country:US
Mailing Address - Phone:903-391-2772
Mailing Address - Fax:
Practice Address - Street 1:7167 COLLEYVILLE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8002
Practice Address - Country:US
Practice Address - Phone:214-412-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96607101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health