Healthcare Provider Details

I. General information

NPI: 1518412097
Provider Name (Legal Business Name): DAWN VICTORIA DICK LMT, NMT, FS, CHHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7856 N WINDHOVER RD
EAGLE MOUNTAIN UT
84005-4344
US

IV. Provider business mailing address

7856 N WINDHOVER RD
EAGLE MOUNTAIN UT
84005-4344
US

V. Phone/Fax

Practice location:
  • Phone: 727-687-0756
  • Fax:
Mailing address:
  • Phone: 727-687-0756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60744
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13789669-4701
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: