Provider Demographics
NPI:1336300722
Name:DOLAN, ANN K
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:K
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 1:69 CANASAWACTA ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1305
Mailing Address - Country:US
Mailing Address - Phone:607-316-3820
Mailing Address - Fax:
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42, COUNTY OFFICE BUILDING
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1602
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health