| Doctor Name: | DOLORES TAIJERON |
| NPI Number: | 1639587520 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | IMF |
| License Number: | IMF-116 |
| Business Practice Address: | 556 E Marine Corps Dr Hagatna, GU - 969105186 |
| Business Phone Number: | 6716464601 |
| Business Fax Number: | 6716465601 |
| Mailing Address: | 361 Santa Cruz Dr, CHALAN PAGO |
| State: | GU |
| Postal Code: | 969105609 |
| Phone Number: | 6716464601 |
| Fax Number: | 6716465601 |
| NPI Enumeration Date: | 07/24/2014 |
| NPI Last Update Date: | 07/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | IMF-116 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GU |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |