Provider Demographics
NPI:1245409754
Name:EARLY, DANA RENEE WYONA (BS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:RENEE WYONA
Last Name:EARLY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:RENEE WYONA
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:52 VEYS DR
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-3935
Mailing Address - Country:US
Mailing Address - Phone:360-425-9856
Mailing Address - Fax:
Practice Address - Street 1:1230 7TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3166
Practice Address - Country:US
Practice Address - Phone:360-636-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health