Provider Demographics
NPI:1346477817
Name:OPITZ-WHITE, DAWN M (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:M
Last Name:OPITZ-WHITE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:OPITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:330 POYNTZ AVE STE 277
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-8039
Mailing Address - Country:US
Mailing Address - Phone:785-202-1689
Mailing Address - Fax:
Practice Address - Street 1:322 HOUSTON ST
Practice Address - Street 2:STE 103
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6497
Practice Address - Country:US
Practice Address - Phone:785-202-1689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1922103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist