Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003362302 |
---|---|
Provider Name | Jennifer Dawson |
First Address | Sarasota, FL 34236-5808 |
Second Address | Sarasota, FL 34236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2016 |
Last Update Date | 28/08/2016 |