Provider Demographics
NPI:1033855515
Name:COLUMBO, DAWN JOY
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:JOY
Last Name:COLUMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9489 CALLUS MILL RD
Mailing Address - Street 2:
Mailing Address - City:LULA
Mailing Address - State:GA
Mailing Address - Zip Code:30554-2114
Mailing Address - Country:US
Mailing Address - Phone:727-729-1949
Mailing Address - Fax:
Practice Address - Street 1:105 WESTPARK DR STE D
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3174
Practice Address - Country:US
Practice Address - Phone:706-883-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty