Provider Demographics
NPI:1275671075
Name:LOTTER-GRIFFIN, DAWN MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIA
Last Name:LOTTER-GRIFFIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4231
Mailing Address - Country:US
Mailing Address - Phone:718-854-8370
Mailing Address - Fax:718-854-8308
Practice Address - Street 1:3512 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4231
Practice Address - Country:US
Practice Address - Phone:718-854-8370
Practice Address - Fax:718-854-8308
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042115A103TC0700X
NY015783-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical