Provider Demographics
NPI:1164213419
Name:DORDAN, MIRANDA MARY (MASTERS DEGREE)
Entity type:Individual
Prefix:MS
First Name:MIRANDA
Middle Name:MARY
Last Name:DORDAN
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 GAMBELL ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4664
Mailing Address - Country:US
Mailing Address - Phone:907-563-1000
Mailing Address - Fax:907-563-2045
Practice Address - Street 1:1231 GAMBELL ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-4664
Practice Address - Country:US
Practice Address - Phone:907-563-1000
Practice Address - Fax:907-563-2045
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health