| Susan Dolan | |
|
5525 Erindale Dr Ste. #107 Colorado Springs CO 80918-6740 | |
| (719) 278-9536 | |
| (719) 266-6025 |
| Full Name | Susan Dolan |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5525 Erindale Dr, Colorado Springs, Colorado |
| Authorized Official Name and Position | Susan Lynn Dolan (PRESIDENT) |
| Authorized Official Contact | 7192789536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Dolan 5525 Erindale Dr Ste. #107 Colorado Springs CO 80918-6740 Ph: (719) 278-9536 | Susan Dolan 5525 Erindale Dr Ste. #107 Colorado Springs CO 80918-6740 Ph: (719) 278-9536 |
| NPI Number | 1144594458 |
|---|---|
| Provider Enumeration Date | 03/05/2012 |
| Last Update Date | 03/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144594458 | NPI | - | NPPES |
| 155048 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 991699 (Colorado) | Primary |
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