Healthcare Provider Details

I. General information

NPI: 1386728962
Provider Name (Legal Business Name): DAWN ELIZABETH NEESE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/15/2024
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 COPPERFIELD BLVD NE STE 102
CONCORD NC
28025-2441
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 704-786-6521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5846
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: