Provider Demographics
NPI:1063837755
Name:DOLATA, IWONA
Entity Type:Individual
Prefix:
First Name:IWONA
Middle Name:
Last Name:DOLATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35483 MONTECRISTO DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5332
Mailing Address - Country:US
Mailing Address - Phone:248-255-6392
Mailing Address - Fax:
Practice Address - Street 1:35483 MONTECRISTO DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5332
Practice Address - Country:US
Practice Address - Phone:248-255-6392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant