Provider Demographics
NPI:1285181867
Name:BASILE-WOOD, DAWNLEE (MA)
Entity Type:Individual
Prefix:MRS
First Name:DAWNLEE
Middle Name:
Last Name:BASILE-WOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9416 DIBOT COURT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667
Mailing Address - Country:US
Mailing Address - Phone:727-512-5804
Mailing Address - Fax:727-245-8796
Practice Address - Street 1:9416 DIBOT COURT
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667
Practice Address - Country:US
Practice Address - Phone:727-512-5804
Practice Address - Fax:727-245-8796
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health