Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 5070 | MA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 5070 | MA |
NPI | 1164616561 |
---|---|
Provider Name | Dr. Michael F. Dorsey |
First Address | Attleboro, MA 02703 |
Second Address | Attleboro, MA 02703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 27/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R84374 | (02) | MA |
W04783 | BCBS (01) | MA |