Doctor Name: | KELLIE JEAN DAWSON |
NPI Number: | 1053429605 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.I.S.W-S |
License Number: | I. 0009062 SUPV |
Business Practice Address: | 21 W Central Ave Delaware, OH - 430151911 |
Business Phone Number: | 6149467571 |
Business Fax Number: | 7408792826 |
Mailing Address: | 21 W Central Ave, DELAWARE |
State: | OH |
Postal Code: | 430151911 |
Phone Number: | 6149467571 |
Fax Number: | 7408792826 |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I. 0009062 SUPV |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |