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General NPI Number Information
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NPI Number | 1225688823
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Entity Type | Individual
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Provider Name | COURTNEY LYN DOLAHER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 09/06/2021
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Provider Practice Location Address
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Address Line | 2600 JAMES RD STE 300
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City | GRANBURY
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State | TX
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Zip | 76049-3123
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Country | US
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Telephone | 978-979-4108
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Fax |
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Provider Business Mailing Address
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Address Line | 801 SUMMER GROVE DRIVE
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-3832
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Country | US
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Telephone | 978-979-4108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 13311
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License Number State | MA
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