Healthcare Provider Details

I. General information

NPI: 1710128871
Provider Name (Legal Business Name): DAWN ELAINE OHLENDORF LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3253 CONGRESS AVE
SAGINAW MI
48602-3106
US

IV. Provider business mailing address

203 S WASHINGTON AVE STE 310
SAGINAW MI
48607-1215
US

V. Phone/Fax

Practice location:
  • Phone: 989-793-4790
  • Fax: 989-793-1641
Mailing address:
  • Phone: 989-793-4790
  • Fax: 989-793-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801090160
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: