Provider Demographics
NPI:1417566704
Name:DOLIN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DOLIN
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 1:8452 DANIEL BOONE PKWY
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:WV
Mailing Address - Zip Code:25081-6028
Mailing Address - Country:US
Mailing Address - Phone:304-744-1112
Mailing Address - Fax:304-744-7910
Practice Address - Street 1:589 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:ALUM CREEK
Practice Address - State:WV
Practice Address - Zip Code:25003-9577
Practice Address - Country:US
Practice Address - Phone:304-744-1112
Practice Address - Fax:304-744-7910
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator