Provider Demographics
NPI:1811479116
Name:DOLAN, PATRICIA (OTR/L)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DOLAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03906-6724
Mailing Address - Country:US
Mailing Address - Phone:207-676-2242
Mailing Address - Fax:207-676-0983
Practice Address - Street 1:47 ELM ST
Practice Address - Street 2:
Practice Address - City:NORTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03906-6724
Practice Address - Country:US
Practice Address - Phone:207-676-2242
Practice Address - Fax:207-676-0983
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1711225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology