Provider Demographics
NPI:1770376766
Name:LAVES, DORA NAYIBE (CMI)
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:NAYIBE
Last Name:LAVES
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 OLD BEN CARTER RD
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-7673
Mailing Address - Country:US
Mailing Address - Phone:850-346-9272
Mailing Address - Fax:
Practice Address - Street 1:473 OLD BEN CARTER RD
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-7673
Practice Address - Country:US
Practice Address - Phone:850-346-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty