Provider Demographics
NPI:1114167822
Name:VAN DOLMAN, CATHRYNE VALENTINE (DT)
Entity Type:Individual
Prefix:
First Name:CATHRYNE
Middle Name:VALENTINE
Last Name:VAN DOLMAN
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 HEMLOCK POINT RD
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3041
Mailing Address - Country:US
Mailing Address - Phone:207-945-6135
Mailing Address - Fax:
Practice Address - Street 1:1372 NEWBURY NECK RD
Practice Address - Street 2:ELIZABETH G. DYER & ASSOCIATES, LLC
Practice Address - City:SURRY
Practice Address - State:ME
Practice Address - Zip Code:04684-3819
Practice Address - Country:US
Practice Address - Phone:207-356-8211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME409730000Medicaid