Healthcare Provider Details

I. General information

NPI: 1013869668
Provider Name (Legal Business Name): DAWN MICHELLE SMALL RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 08/24/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LEIGHTONS CORNER RD
STRAFFORD NH
03884-6356
US

IV. Provider business mailing address

9 LEIGHTONS CORNER RD
STRAFFORD NH
03884-6356
US

V. Phone/Fax

Practice location:
  • Phone: 603-491-6806
  • Fax:
Mailing address:
  • Phone: 603-491-6806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number276
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: