Provider Demographics
NPI:1477268555
Name:YAZZIE, DAWN A (NCC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:YAZZIE
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1252
Mailing Address - Street 2:
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-1252
Mailing Address - Country:US
Mailing Address - Phone:480-365-9034
Mailing Address - Fax:
Practice Address - Street 1:50 OLD CRYSTAL ROAD
Practice Address - Street 2:
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504-1252
Practice Address - Country:US
Practice Address - Phone:480-365-9034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health