Individual
KELLY LYNN VAN DOLSON
Active
Individual
KELLY LYNN VAN DOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
119709
MA
1041C0700X
Clinical Social Worker
Primary
2134
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3117655
—
NH
Enumeration date
09/19/2011
Last updated
08/20/2019
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