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NPI 1265487227

NPI 1265487227 : DAWN M MALONE LISW-S : DAYTON, OH

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General NPI Number Information
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    NPI Number           |    1265487227
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    Entity Type          |    Individual 
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    Provider Name        |    DAWN M MALONE LISW-S
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/24/2006
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    Last Update Date     |    06/12/2013
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Provider Practice Location Address
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    Address Line         |    1766 EMMONS AVE 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45410-3466
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    Country              |    US
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    Telephone            |    513-319-3400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1766 EMMONS AVE 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45410-3466
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    Country              |    US
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    Telephone            |    513-319-3400
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    I-22724-SUPV
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    License Number State |    OH
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