Provider Demographics
NPI:1528104973
Name:DOLAN-ASH, MARY (MS)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:DOLAN-ASH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:3235 JACKSON ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704
Mailing Address - Country:US
Mailing Address - Phone:727-551-0722
Mailing Address - Fax:
Practice Address - Street 1:880 6TH ST SOUTH #170
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-767-8989
Practice Address - Fax:727-767-8998
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY553231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist