Healthcare Provider Details

I. General information

NPI: 1043363963
Provider Name (Legal Business Name): DAWN SHANER GABLE PHD HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHANER DAWN GABLE PHD HSPP

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 W FRANKLIN ST
EVANSVILLE IN
47710-1137
US

IV. Provider business mailing address

9000 MARFIELD CT
EVANSVILLE IN
47712-5417
US

V. Phone/Fax

Practice location:
  • Phone: 812-491-1805
  • Fax: 812-491-1929
Mailing address:
  • Phone: 812-685-0065
  • Fax: 812-491-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20041439A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: