Healthcare Provider Details

I. General information

NPI: 1568921203
Provider Name (Legal Business Name): MEGHAN LEEANN DAWSON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGHAN LEEANN BECKER

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 W JACKSON ST
MEXICO MO
65265-2712
US

IV. Provider business mailing address

216 W JACKSON ST
MEXICO MO
65265-2712
US

V. Phone/Fax

Practice location:
  • Phone: 573-982-9170
  • Fax: 417-944-1440
Mailing address:
  • Phone: 573-982-9170
  • Fax: 417-944-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2019006986
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: