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General NPI Number Information
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NPI Number | 1902945512
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Entity Type | Individual
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Provider Name | RALPH JOSEPH DOLAN LICSW
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 230 MAPLE ST
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City | HOLYOKE
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State | MA
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Zip | 01040-5144
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Country | US
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Telephone | 141-353-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 267 TURKEY HILL RD
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City | FLORENCE
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State | MA
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Zip | 01062-9613
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Country | US
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Telephone | 141-367-2174
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 100919
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License Number State | MA
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