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General NPI Number Information
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NPI Number | 1265700223
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Entity Type | Individual
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Provider Name | DIANE MARIE DOOLAN M.S., P.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 20 FARM TO MARKET RD
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City | BREWSTER
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State | NY
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Zip | 10509-2703
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Country | US
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Telephone | 845-279-4018
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Fax | 845-279-8154
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Provider Business Mailing Address
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Address Line | 67 KINGS RD
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City | ROCK TAVERN
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State | NY
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Zip | 12575-5131
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Country | US
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Telephone | 845-497-7647
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | NY
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