Provider Demographics
NPI:1518095330
Name:DOLAN, DONA L
Entity Type:Individual
Prefix:
First Name:DONA
Middle Name:L
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 1:142A DANIELSON PIKE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FOSTER
Mailing Address - State:RI
Mailing Address - Zip Code:02825-1475
Mailing Address - Country:US
Mailing Address - Phone:401-647-2999
Mailing Address - Fax:401-647-2799
Practice Address - Street 1:142A DANIELSON PIKE
Practice Address - Street 2:SUITE 3
Practice Address - City:FOSTER
Practice Address - State:RI
Practice Address - Zip Code:02825-1475
Practice Address - Country:US
Practice Address - Phone:401-647-2999
Practice Address - Fax:401-647-2799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW101071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical