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NPI Code Detail

MEDICARE: HEATHER SHANNON DAWSON M.A.

MEDICARE: HEATHER SHANNON DAWSON M.A.
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
1101YM0800XMental Health CounselorMH12552FL

General Provider Information

NPI Number : 1073886677
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER SHANNON DAWSON M.A.
Provider Business Mailing Address
First Line : 3544 EDGEWATER DR
Second Line :
City : ORLANDO
State : FL
Zip : 32804-2922
Country : US
Telephone Number : 407-616-2888
Fax Number :
Provider Business Practice Location Address
First Line : 3544 EDGEWATER DR
Second Line :
City : ORLANDO
State : FL
Zip : 32804-2922
Country : US
Telephone Number : 407-616-2888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2012
Last Update Date : 02/06/2017

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Directions to “ HEATHER SHANNON DAWSON M.A.” Practice Location

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