Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003351669 |
---|---|
Provider Name | Dawn Marie Earles |
First Address | Slidell, LA 70458-5239 |
Second Address | Slidell, LA 70458-5239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2017 |
Last Update Date | 05/01/2017 |