Doctor Name: | JESSIE DAWSON |
NPI Number: | 1033546429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A |
License Number: | A10461 |
Business Practice Address: | 1019 W 6th Ave Gastonia, NC - 280523961 |
Business Phone Number: | 7573391149 |
Business Fax Number: | |
Mailing Address: | 1019 W 6th Ave, GASTONIA |
State: | NC |
Postal Code: | 280523961 |
Phone Number: | 7573391149 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2013 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | A10461 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |