Provider Demographics
NPI:1326737214
Name:DOLAN, CORA NICOLE (AUD)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:NICOLE
Last Name:DOLAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CORA
Other - Middle Name:
Other - Last Name:PAOLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:524 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:44077-5728
Mailing Address - Country:US
Mailing Address - Phone:440-520-2188
Mailing Address - Fax:
Practice Address - Street 1:5700 MONROE ST UNIT 310
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2768
Practice Address - Country:US
Practice Address - Phone:440-520-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02470231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist