Provider Demographics
NPI:1295899375
Name:DOLAN, ANNE CHRISTINE (AUD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CHRISTINE
Last Name:DOLAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:RBC T103
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-7191
Mailing Address - Fax:216-844-3668
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:RBC T103
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7191
Practice Address - Fax:216-844-3668
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01599237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4245001Medicare PIN