Provider Demographics
NPI:1114234911
Name:RIERSON, DAWN MARIE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:RIERSON
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 1:6551 MCCARRAN ST
Mailing Address - Street 2:APT. 1111
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-1435
Mailing Address - Country:US
Mailing Address - Phone:702-883-5791
Mailing Address - Fax:
Practice Address - Street 1:6551 MCCARRAN ST
Practice Address - Street 2:APT. 1111
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-1435
Practice Address - Country:US
Practice Address - Phone:702-883-5791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst