Provider Demographics
NPI:1609920867
Name:DOLEJS, AIMEE CATHRINE (CERTIFIED SCHOOL PSY)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CATHRINE
Last Name:DOLEJS
Suffix:
Gender:F
Credentials:CERTIFIED SCHOOL PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11425 N DYSART RD
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-9233
Mailing Address - Country:US
Mailing Address - Phone:623-876-7542
Mailing Address - Fax:
Practice Address - Street 1:11425 N DYSART RD
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-9233
Practice Address - Country:US
Practice Address - Phone:623-876-7542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973009Medicaid