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NPI Code Detail

MEDICARE: DANIELA YVONNE DAWSON

MEDICARE:   DANIELA YVONNE DAWSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1558912527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA YVONNE DAWSON
Provider Business Mailing Address
First Line : 47 W STONE AVE
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-2958
Country : US
Telephone Number : 847-306-9843
Fax Number :
Provider Business Practice Location Address
First Line : 47 W STONE AVE
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-2958
Country : US
Telephone Number : 720-822-9625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2019
Last Update Date : 09/21/2019

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Directions to “ DANIELA YVONNE DAWSON ” Practice Location

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