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General NPI Number Information
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NPI Number | 1265596274
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Entity Type | Individual
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Provider Name | DAWN MICHELLE JETT LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 3540 WHEELER RD STE 210
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City | AUGUSTA
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State | GA
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Zip | 30909-1879
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Country | US
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Telephone | 706-951-2182
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Fax |
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Provider Business Mailing Address
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Address Line | 2641 RAYMOND AVE
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City | AUGUSTA
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State | GA
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Zip | 30904-5338
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Country | US
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Telephone | 706-951-2182
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Fax | 706-364-0401
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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 | CSW003221
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License Number State | GA
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