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General NPI Number Information
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NPI Number | 1336738269
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Entity Type | Organization
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Legal Business Name | CAYA
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 621 N MAIN ST STE 430
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City | GRAPEVINE
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State | TX
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Zip | 76051-9218
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Country | US
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Telephone | 214-945-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 7575 CHAUCER PL APT 2907
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City | DALLAS
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State | TX
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Zip | 75237-3550
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Country | US
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Telephone | 559-903-7942
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREG DAWSON II
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Credential | LCSW
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Telephone | 559-903-7942
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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 |
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License Number State |
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