MEDICARE: MS. DAWN HALE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency		OH

General Provider Information

NPI Number	:	1508569252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN HALE

Provider Business Mailing Address
First Line	:	5123 PHILIP AVE
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1445
Country	:	US
Telephone Number	:	216-849-9955
Fax Number	:

Provider Business Practice Location Address
First Line	:	5123 PHILIP AVE
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1445
Country	:	US
Telephone Number	:	216-849-9955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	03/22/2023

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