Provider Information for 1851689764
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LISA DORFMAN MS,RD,CSSD.LMHC
Sex: Female
NPI: 1851689764
Last Updated: 2011-07-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1851689764 | ||||||||||||
| Enumeration Date | 2011-07-12 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1400 NW 12TH AVE MIAMI, FL 33136-1003 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 1400 NW 12TH AVE MIAMI, FL 33136-1003 United States Phone: 305-854-1065 | Fax: | ||||||||||||
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