Provider Demographics
NPI:1346503133
Name:CARPENTER, DAWN JANINE (SPECIAL ED TEACHER)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:JANINE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1209
Mailing Address - Country:US
Mailing Address - Phone:315-797-4080
Mailing Address - Fax:315-797-7249
Practice Address - Street 1:326 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1209
Practice Address - Country:US
Practice Address - Phone:315-797-4080
Practice Address - Fax:315-797-7249
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist