Healthcare Provider Details

I. General information

NPI: 1568798023
Provider Name (Legal Business Name): DANIELLE CHRISTINE DOLENA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6877 MEMORIAL RD
NEW TRIPOLI PA
18066-3849
US

IV. Provider business mailing address

6877 MEMORIAL RD
NEW TRIPOLI PA
18066-3849
US

V. Phone/Fax

Practice location:
  • Phone: 570-926-1304
  • Fax:
Mailing address:
  • Phone: 570-926-1304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016051
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: