Provider Demographics
NPI:1174742266
Name:DOLINSHEK, DIANE LOUISE (PT)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LOUISE
Last Name:DOLINSHEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15687 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3303
Mailing Address - Country:US
Mailing Address - Phone:248-410-3059
Mailing Address - Fax:
Practice Address - Street 1:15687 BUCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-3303
Practice Address - Country:US
Practice Address - Phone:248-410-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist