Healthcare Provider Details

I. General information

NPI: 1548329428
Provider Name (Legal Business Name): DEBORAH ANN DOLAWAY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S SPOONER ST ISIS PSYCHOTHERAPY
PLYMOUTH MA
02360-4446
US

IV. Provider business mailing address

5 HEATHER HILL RD
SANDWICH MA
02563-2614
US

V. Phone/Fax

Practice location:
  • Phone: 508-830-2414
  • Fax: 508-830-2399
Mailing address:
  • Phone: 508-830-2414
  • Fax: 508-830-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107003
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: