Doctor Name: | MRS. REBEKAH GOOD DOREAU |
NPI Number: | 1003003245 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 6110 Shallowford Rd Suite B Chattanooga, TN - 374211894 |
Business Phone Number: | 8882914357 |
Business Fax Number: | 4232966384 |
Mailing Address: | 6110 Shallowford Rd, Suite B CHATTANOOGA |
State: | TN |
Postal Code: | 374211894 |
Phone Number: | 8882914357 |
Fax Number: | 4232966384 |
NPI Enumeration Date: | 10/02/2007 |
NPI Last Update Date: | 01/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |