Provider Demographics
NPI:1043442171
Name:DOLAN, CHRISTINE (LCP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DOLAN
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 1/2 MASSACHUSETTS ST STE 204
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2257
Mailing Address - Country:US
Mailing Address - Phone:785-592-1377
Mailing Address - Fax:
Practice Address - Street 1:729 1/2 MASSACHUSETTS ST STE 206
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2257
Practice Address - Country:US
Practice Address - Phone:785-592-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1485103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist