Provider Demographics
NPI:1346023579
Name:WESLEY, DAWN M (RMHCI, LPCA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:WESLEY
Suffix:
Gender:F
Credentials:RMHCI, LPCA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:WESLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RMHCI, LPCA
Mailing Address - Street 1:12201 CITRUS LEAF DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-5630
Mailing Address - Country:US
Mailing Address - Phone:813-505-6112
Mailing Address - Fax:
Practice Address - Street 1:208 APOLLO BEACH BLVD STE 107
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2250
Practice Address - Country:US
Practice Address - Phone:813-439-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284244101YM0800X
FLIMH2289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health