Provider Demographics
NPI:1154817500
Name:DAWI, IKRAN
Entity Type:Individual
Prefix:
First Name:IKRAN
Middle Name:
Last Name:DAWI
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 1:4609 W ALICIA DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2302
Mailing Address - Country:US
Mailing Address - Phone:602-388-9107
Mailing Address - Fax:
Practice Address - Street 1:4609 W ALICIA DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2302
Practice Address - Country:US
Practice Address - Phone:602-388-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services