Individual
DAMARIS LIDIA DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
2106 GALLOWS RD UNIT E, VIENNA, VA 22182-3961
(571) 766-8455
Mailing address
2106 GALLOWS RD STE G, VIENNA, VA 22182-3961
(703) 957-9256
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
08430
MD
235Z00000X
Speech-Language Pathologist
Primary
2202008797
VA
235Z00000X
Speech-Language Pathologist
3047
PR
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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