Provider Demographics
NPI:1316224538
Name:BAWA, DAWN R
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:R
Last Name:BAWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CHESTNUT AVENUE
Mailing Address - Street 2:PO BOX 352
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16603-0352
Mailing Address - Country:US
Mailing Address - Phone:814-946-5411
Mailing Address - Fax:814-940-8471
Practice Address - Street 1:500 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-5215
Practice Address - Country:US
Practice Address - Phone:814-943-0414
Practice Address - Fax:814-943-6198
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor