Provider Demographics
NPI:1245763945
Name:KING, DAWN MARIE (MED)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:106 HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1308
Mailing Address - Country:US
Mailing Address - Phone:845-268-1795
Mailing Address - Fax:845-268-3964
Practice Address - Street 1:140 ROUTE 303
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-5906
Practice Address - Country:US
Practice Address - Phone:845-268-1795
Practice Address - Fax:845-268-3964
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health