Provider Demographics
NPI:1366594574
Name:DESIGNS BY DOLLIE, L.L.C.
Entity type:Organization
Organization Name:DESIGNS BY DOLLIE, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALY
Authorized Official - Middle Name:H
Authorized Official - Last Name:ENSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-466-1917
Mailing Address - Street 1:67 COLFAX RD
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2310
Mailing Address - Country:US
Mailing Address - Phone:609-466-1917
Mailing Address - Fax:609-466-3429
Practice Address - Street 1:67 COLFAX RD
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2310
Practice Address - Country:US
Practice Address - Phone:609-466-1917
Practice Address - Fax:609-466-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00016100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty