Provider Demographics
NPI:1215299318
Name:STOLZE, DANA M (MA)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:M
Last Name:STOLZE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3362 ANNA RUBY LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4578
Mailing Address - Country:US
Mailing Address - Phone:770-789-6270
Mailing Address - Fax:
Practice Address - Street 1:3362 ANNA RUBY LN
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4578
Practice Address - Country:US
Practice Address - Phone:770-789-6270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist