Provider Demographics
NPI:1952561722
Name:DOLAN, VIRGINIA LEPORI
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:LEPORI
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 1:1110 BENFIELD BLVD
Mailing Address - Street 2:SUITE J FRONT
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-2540
Mailing Address - Country:US
Mailing Address - Phone:410-987-2031
Mailing Address - Fax:410-987-4710
Practice Address - Street 1:1110 BENFIELD BLVD
Practice Address - Street 2:SUITE J FRONT
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2540
Practice Address - Country:US
Practice Address - Phone:410-987-2031
Practice Address - Fax:410-987-4410
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool