Healthcare Provider Details

I. General information

NPI: 1083070882
Provider Name (Legal Business Name): DAWN CAHILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 HIGHWAY A
WASHINGTON MO
63090-5498
US

IV. Provider business mailing address

3021 HIGHWAY A
WASHINGTON MO
63090-5498
US

V. Phone/Fax

Practice location:
  • Phone: 636-432-5567
  • Fax: 636-432-5567
Mailing address:
  • Phone: 636-432-5567
  • Fax: 636-432-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number81970
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2006008065
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: