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NPI Code Detail

MEDICARE: DR. DAWN S O'MALLEY PSY.D.

MEDICARE: DR. DAWN S O'MALLEY PSY.D.
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
1103TC0700XClinical Psychologist2244NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730246620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAWN S O'MALLEY PSY.D.
Provider Business Mailing Address
First Line : 5821 FAIRVIEW RD
Second Line : SUITE 218
City : CHARLOTTE
State : NC
Zip : 28209-5601
Country : US
Telephone Number : 704-554-0443
Fax Number : 704-643-5965
Provider Business Practice Location Address
First Line : 5821 FAIRVIEW RD
Second Line : SUITE 218
City : CHARLOTTE
State : NC
Zip : 28209-5601
Country : US
Telephone Number : 704-554-0443
Fax Number : 704-643-5965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 03/18/2008

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