Provider Demographics
NPI:1215549282
Name:DOLAN, SARA JANE
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JANE
Last Name:DOLAN
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 1:409 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43793-1218
Mailing Address - Country:US
Mailing Address - Phone:740-312-9067
Mailing Address - Fax:
Practice Address - Street 1:409 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793-1218
Practice Address - Country:US
Practice Address - Phone:740-312-9067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator