Provider Demographics
NPI:1477290583
Name:DOLFI, KATE MARIE
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MARIE
Last Name:DOLFI
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 1:1850 HYLAND DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48875-8508
Mailing Address - Country:US
Mailing Address - Phone:517-253-5084
Mailing Address - Fax:
Practice Address - Street 1:1850 HYLAND DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:MI
Practice Address - Zip Code:48875-8508
Practice Address - Country:US
Practice Address - Phone:517-253-5084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011106961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical