Individual
ROBERTA LYNN DOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 S 11TH ST, NILES, MI 49120-3408
(269) 684-7741
Mailing address
2330 E MAIN ST LOT 68, NILES, MI 49120-4392
(269) 635-7756
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
110082
MI
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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