Healthcare Provider Details

I. General information

NPI: 1699729251
Provider Name (Legal Business Name): DEBORAH HOOD DAWES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S RAINBOW RD
ROGERS AR
72758-8821
US

IV. Provider business mailing address

264 COUNTY ROAD 207
EUREKA SPRINGS AR
72632-9623
US

V. Phone/Fax

Practice location:
  • Phone: 479-254-1144
  • Fax: 479-254-1099
Mailing address:
  • Phone: 479-253-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number05-4P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: