Provider Demographics
NPI:1740599190
Name:DOLL, LAURA KIM (MA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KIM
Last Name:DOLL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 WALL ST.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718
Mailing Address - Country:US
Mailing Address - Phone:608-274-8294
Mailing Address - Fax:608-274-8783
Practice Address - Street 1:5310 WALL ST.
Practice Address - Street 2:SUITE 500
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718
Practice Address - Country:US
Practice Address - Phone:608-274-8294
Practice Address - Fax:608-274-8783
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)