Provider Demographics
NPI:1306718044
Name:DOLO, NEWMAN NIMUBAH
Entity type:Individual
Prefix:
First Name:NEWMAN
Middle Name:NIMUBAH
Last Name:DOLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 IDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3120
Mailing Address - Country:US
Mailing Address - Phone:216-469-1335
Mailing Address - Fax:
Practice Address - Street 1:9501 IDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44144-3120
Practice Address - Country:US
Practice Address - Phone:216-469-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9626667508ND106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty