MEDICARE: MS. DAWN MICHELLE DOUCETTE MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1023225208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN MICHELLE DOUCETTE MSW

Provider Business Mailing Address
First Line	:	2100 GULF BLVD
Second Line	:	UNIT 8
City	:	BELLEAIR BEACH
State	:	FL
Zip	:	33786
Country	:	US
Telephone Number	:	941-320-9819
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 GULF BLVD
Second Line	:	UNIT 8
City	:	BELLEAIR BEACH
State	:	FL
Zip	:	33786
Country	:	US
Telephone Number	:	941-320-9819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	02/20/2013

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