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Organization

SUSAN DOLAN

Active
Parent organization
SUSAN DOLAN
Organization subpart
Yes

Provider details

NPI number
Legal business name
SUSAN DOLAN
Authorized official
MRS. SUSAN LYNN DOLAN LCSW (PRESIDENT)
(719) 278-9536
Entity
Organization

Contact information

Practice address
5525 ERINDALE DR, STE. #107, COLORADO SPRINGS, CO 80918-6740
(719) 278-9536
(719) 266-6025
Mailing address
5525 ERINDALE DR, STE. #107, COLORADO SPRINGS, CO 80918-6740
(719) 278-9536
(719) 266-6025

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
991699
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
155048
CO
Enumeration date
03/05/2012
Last updated
03/05/2012
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