Provider Demographics
NPI:1215193016
Name:LOSE, DULCIE
Entity Type:Individual
Prefix:
First Name:DULCIE
Middle Name:
Last Name:LOSE
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 1:1380 RTE 286 HWY E
Mailing Address - Street 2:524
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1461
Mailing Address - Country:US
Mailing Address - Phone:724-465-0369
Mailing Address - Fax:
Practice Address - Street 1:1380 RTE 286 HWY E
Practice Address - Street 2:524
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1461
Practice Address - Country:US
Practice Address - Phone:724-465-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health