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General NPI Number Information
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NPI Number | 1699071829
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Entity Type | Individual
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Provider Name | DAWN RENAE HODI LMT
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Gender | Female
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Dates
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Enumeration Date | 02/05/2011
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Last Update Date | 02/05/2011
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Provider Practice Location Address
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Address Line | 5600 W BROWN DEER RD SUITE 208
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City | BROWN DEER
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State | WI
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Zip | 53223-2311
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Country | US
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Telephone | 441-480-7760
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Fax |
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Provider Business Mailing Address
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Address Line | 2834 N 62ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53210-2117
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Country | US
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Telephone | 414-807-7609
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2513-146
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License Number State | WI
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