Provider Demographics
NPI:1235257908
Name:WELBORN-MABREY, DAWN LYNN (PT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LYNN
Last Name:WELBORN-MABREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 SEVEN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ELBERFELD
Mailing Address - State:IN
Mailing Address - Zip Code:47613-9468
Mailing Address - Country:US
Mailing Address - Phone:812-983-4309
Mailing Address - Fax:812-983-3071
Practice Address - Street 1:10600 SEVEN HILLS RD
Practice Address - Street 2:
Practice Address - City:ELBERFELD
Practice Address - State:IN
Practice Address - Zip Code:47613-9468
Practice Address - Country:US
Practice Address - Phone:812-983-4309
Practice Address - Fax:812-983-3071
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001788A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics