Provider Demographics
NPI:1316226053
Name:DAWSON, AURYA CHANNELLE
Entity Type:Individual
Prefix:
First Name:AURYA
Middle Name:CHANNELLE
Last Name:DAWSON
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 1:836 BUSSORA ROSE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-2425
Mailing Address - Country:US
Mailing Address - Phone:702-689-5347
Mailing Address - Fax:
Practice Address - Street 1:836 BUSSORA ROSE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-2425
Practice Address - Country:US
Practice Address - Phone:702-689-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst