Provider Demographics
NPI:1326156860
Name:DAWSON, REBECCA WOOLLEY (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:WOOLLEY
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:140 TUACAHN DR UNIT 74
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-6522
Mailing Address - Country:US
Mailing Address - Phone:435-627-8100
Mailing Address - Fax:
Practice Address - Street 1:2480 RED CLIFFS DR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5457
Practice Address - Country:US
Practice Address - Phone:435-673-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT309412-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional