Healthcare Provider Details

I. General information

NPI: 1518095330
Provider Name (Legal Business Name): DONA L DOLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142A DANIELSON PIKE SUITE 3
FOSTER RI
02825-1475
US

IV. Provider business mailing address

142A DANIELSON PIKE SUITE 3
FOSTER RI
02825-1475
US

V. Phone/Fax

Practice location:
  • Phone: 401-647-2999
  • Fax: 401-647-2799
Mailing address:
  • Phone: 401-647-2999
  • Fax: 401-647-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW10107
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: